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The following is a summary of “Effects of low frequency repetitive transcranial magnetic stimulation on motor recovery in subacute stroke patients with different motor evoked potential status: a randomized controlled trial,” published in the October 2024 issue of Neurology by Qian et al.     

Repetitive transcranial magnetic stimulation (rTMS) may promote motor recovery in patients with stroke by enhancing cortical excitability, with motor-evoked potential (MEP) status influencing outcomes.  

Researchers conducted a prospective study to explore the effects of low-frequency rTMS on motor function and cortical excitability in patients with stroke having different MEP statuses.  

They enrolled 80 patients with stroke and divided them 2 two groups based on MEP status (− or +) in the affected hemisphere. Each group was randomly assigned to either active or sham rTMS. In addition to conventional rehabilitation, patients received 20 sessions of rTMS at 1 Hz frequency over 4 weeks. Motor function and cortical excitability were assessed at baseline, 4 weeks, and 8 weeks using the Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Shoulder Abduction Finger Extension (SAFE), Barthel Index (BI), bilateral resting motor threshold (rMT), MEP amplitude, central motor conduction time (CMCT), and interhemispheric asymmetry (IHA).  

The results showed that at 4 weeks, FMA and NIHSS score changes were significantly greater in the 1 Hz MEP(+) group compared to the other groups (P<0.001). Patients with MEP(+) also experienced significant changes in bilateral cortical excitability (P<0.05). By 8 weeks, NIHSS, FMA, SAFE, and Barthel Index (BI) scores improved more in the 1 Hz MEP(+) group (P<0.001). The rTMS intervention reduced unaffected cortical excitability and enhanced affected cortical excitability in patients with MEP(+) (P<0.05). The FMA motor score changes correlated with decreased unaffected MEP amplitude (r = −0.401, P=0.010) and decreased affected resting motor threshold (r = −0.584, P<0.001).  

They concluded low-frequency rTMS was more effective in improving motor recovery and cortical excitability in patients with stroke with MEP than those without MEP.  

Source: frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1460925/full