Cortical and spinal excitability changes after repetitive transcranial magnetic stimulation combined to physiotherapy in stroke spastic patients

Objective Repetitive Transcranial Magnetic Stimulation (rTMS) has been used to treat post-stroke upper limb spasticity (ULS) in addition to physiotherapy (PT). To determine whether rTMS associated with PT modulates cortical and spinal cord excitability as well as decreases ULS of post-stroke patient...

Full description

Saved in:
Bibliographic Details
Published in:Neurological sciences 2019-06, Vol.40 (6), p.1199-1207
Main Authors: dos Santos, Rebeka Borba Costa, Galvão, Silvana Carla Barros, Frederico, Labibe Mara Pinel, Amaral, Nathália Serrano Lucena, Carneiro, Maíra Izzadora Souza, de Moura Filho, Alberto Galvão, Piscitelli, Daniele, Monte-Silva, Kátia
Format: Article
Language:English
Subjects:
Cortex
Excitability
Magnetic fields
Median nerve
Medicine
Medicine & Public Health
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Original Article
Patients
Physical therapy
Psychiatry
Spasticity
Spinal cord
Stroke
Transcranial magnetic stimulation
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective Repetitive Transcranial Magnetic Stimulation (rTMS) has been used to treat post-stroke upper limb spasticity (ULS) in addition to physiotherapy (PT). To determine whether rTMS associated with PT modulates cortical and spinal cord excitability as well as decreases ULS of post-stroke patients. Methods Twenty chronic patients were randomly assigned to either the intervention group-1 Hz rTMS on the unaffected hemisphere and PT, or control group- sham stimulation and PT, for ten sessions. Before and after sessions, ULS was measured using the modified Ashworth scale and cortical excitability using the output intensity of the magnetic stimulator (MSO). The spinal excitability was measured by the Hmax/Mmax ratio of the median nerve at baseline, at the end of treatment, and at the 4-week follow-up. Results The experimental group showed at the end of treatment an enhancement of cortical excitability, i.e., lower values of MSO, compared to control group ( p  = 0.044) and to baseline ( p  = 0.028). The experimental group showed a decreased spinal cord excitability at the 4-week follow-up compared to control group ( p  = 0.021). ULS decreased by the sixth session in the experimental group ( p  
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-019-03765-y