Poster No:
69
Submission Type:
Abstract Submission
Authors:
Sam Chi Chung Chan1, Bo Chen2
Institutions:
1The Hong Kong Polytechnic University, Hong Kong, AK, 2Department of Rehabilitation, The Affiliated Hospital of Southwest Medical University, Luzhou , AK
First Author:
Co-Author:
Bo Chen
Department of Rehabilitation, The Affiliated Hospital of Southwest Medical University
Luzhou , AK
Introduction:
Patients with stroke often experience motor and non-motor deficits affecting both upper and lower limb function, impacting their independence in activities of daily living (ADL) and social participation (Kwakkel et al., 2010). Repeated transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation tool, has shown promise in improving motor function in stroke survivors (Lefaucheur et al., 2020). However, the neurophysiological mechanisms by which rTMS improves clinical functioning in patients with severe upper limb dysfunction remain unclear (Guo et al., 2021; Xia et al., 2022). This study aims to investigate the changes in clinical functions and neurophysiological activities after rTMS treatment in patients with severe upper limb dysfunction, and to explore correlations between these changes.
Methods:
The neurophysiological activities were detected via resting state EEG, including the cortical activity level (cortical oscillation power and pairwise derived brain symmetry index (pdBSI)) and brain networks level (functional connectivity, path length and global efficiency of brain network). Both participants and assessors were blinded to the group allocation.
Results:
No significant baseline demographic differences were found between the HF-rTMS and LF-rTMS groups, except for gender. Significant improvements in FMA-UE scores were observed in the LF-rTMS group but not in the HF-rTMS group. Both groups showed significant improvements in NIHSS scores. No significant differences were found between the groups in FMA-UE, NIHSS, or MBI scores post-rTMS. Significant cortical activity changes were noted in the LF-rTMS group, particularly in θpdBSI and αpdBSI. Significant differences between the groups were found in δpdBSI and β1pdBSI in the frontal lobes. The HF group showed reduced path length and increased global efficiency in the β2 oscillation rhythm band, with significant differences between the groups. Correlation analysis revealed no relationship between changes in FMA-UE, MBI scores, and EEG markers. However, improvements in NIHSS scores in the LF-rTMS group correlated with changes in cortical activities, while improvements in the HF-rTMS group correlated with brain network path length.
Conclusions:
LF-rTMS on the unaffected brain improved upper limb function and stroke severity in patients with severe upper limb dysfunction, while HF-rTMS reduced stroke severity. No correlation was found between rTMS effects on upper limb function and neurophysiological activities. However, improvements in stroke severity correlated with resting-state EEG changes, providing insights into the brain mechanisms underlying rTMS clinical outcomes. These findings suggest that LF-rTMS may be more effective for enhancing upper limb function in stroke patients, while both HF- and LF-rTMS can reduce stroke severity, potentially through different neurophysiological pathways. Further research is needed to fully understand the mechanisms and optimize rTMS protocols for stroke rehabilitation.
Brain Stimulation:
TMS 1
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 2
Modeling and Analysis Methods:
Connectivity (eg. functional, effective, structural)
Motor Behavior:
Motor Behavior Other
Keywords:
Electroencephaolography (EEG)
Motor
Transcranial Magnetic Stimulation (TMS)
1|2Indicates the priority used for review
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Please indicate below if your study was a "resting state" or "task-activation” study.
Resting state
Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
Patients
Was this research conducted in the United States?
No
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel?
NOTE: Any human subjects studies without IRB approval will be automatically rejected.
Yes
Were any animal research approved by the relevant IACUC or other animal research panel?
NOTE: Any animal studies without IACUC approval will be automatically rejected.
Not applicable
Please indicate which methods were used in your research:
EEG/ERP
TMS
Behavior
Provide references using APA citation style.
Guo, Z., Jin, Y., Bai, X., Jiang, B., He, L., McClure, M. A., & Mu, Q. (2021a). Distinction of High- and Low-Frequency Repetitive Transcranial Magnetic Stimulation on the Functional Reorganization of the Motor Network in Stroke Patients. Neural Plasticity, 2021, 1–11. https://doi.org/10.1155/2021/8873221
Kwakkel, G., Lannin, N. A., Borschmann, K., English, C., Ali, M., Churilov, L., Saposnik, G., Winstein, C., van Wegen, E. E., Wolf, S. L., Krakauer, J. W., & Bernhardt, J. (2017). Standardized measurement of sensorimotor recovery in stroke trials: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable. International Journal of Stroke, 12(5), 451–461. https://doi.org/10.1177/1747493017711813
Lefaucheur, J.-P. (2009). Methods of therapeutic cortical stimulation. Neurophysiologie Clinique/Clinical Neurophysiology, 39(1), 1–14. https://doi.org/10.1016/j.neucli.2008.11.001
Xia, Y., Xu, Y., Li, Y., Lu, Y., & Wang, Z. (2022). Comparative Efficacy of Different Repetitive Transcranial Magnetic Stimulation Protocols for Stroke: A Network Meta-Analysis. Frontiers in Neurology, 13, 918786. https://doi.org/10.3389/fneur.2022.918786
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