AUTHOR=Dionísio Ana , Gouveia Rita , Castelhano João , Duarte Isabel Catarina , Santo Gustavo C. , Sargento-Freitas João , Duecker Felix , Castelo-Branco Miguel 

TITLE=The Role of Continuous Theta Burst TMS in the Neurorehabilitation of Subacute Stroke Patients: A Placebo-Controlled Study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.749798

DOI=10.3389/fneur.2021.749798

ISSN=1664-2295

ABSTRACT=Objectives: Transcranial magnetic stimulation, in particular continuous theta burst (cTBS), has been proposed for stroke rehabilitation, based on the concept that inhibition of the healthy hemisphere helps promoting the recovery of the lesioned one. We aimed to study its effects on cortical excitability, oscillatory patterns and motor function, the main aim being to identify potentially beneficial neurophysiological effects. Materials and Methods: We applied randomized real or placebo stimulation over the unaffected primary motor cortex of ten subacute (7 ± 3 days) post-stroke patients. Neurophysiological measurements were performed using electroencephalography and electromyography. Motor function was assessed with the Wolf Motor Function Test. We performed a repeated measure study with the recordings taken pre-, post-cTBS and at 3 months’ follow-up. Results: We investigated changes in motor rhythms during arm elevation and thumb opposition tasks and found significant changes in beta power of the affected thumb’s opposition, specifically after real cTBS. Our results are consistent with an excitatory response (increase in event-related desynchronization) in the sensorimotor cortical areas of the affected hemisphere, after stimulation. Conclusions: Consistently with the theoretical prediction, this contralateral inhibitory stimulation paradigm changes neurophysiology, leading to a significant excitatory impact on the cortical oscillatory patterns of the contralateral hemisphere. Our results provide evidence for the potential role of continuous TBS in the neurorehabilitation of post-stroke patients.