AUTHOR=Cheng Siman , Xin Rong , Zhao Yan , Wang Pu , Feng Wuwei , Liu Peng 

TITLE=Evaluation of fMRI activation in post-stroke patients with movement disorders after repetitive transcranial magnetic stimulation: a scoping review

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1192545

DOI=10.3389/fneur.2023.1192545

ISSN=1664-2295

ABSTRACT=Background Movement disorders are one of the most common stroke residual
effects, which cause a heavy burden on their families and society. Repetitive
transcranial magnetic stimulation (rTMS) could change reorganization and plasticity in
the brain network, which has been suggested as an alternative rehabilitative treatment
for enhancing stroke recovery. Functional magnetic resonance imaging (fMRI) have
been served as a promising tool to explore neural mechanisms underlying rTMS
intervention.
Object Our primary goal is to better understand the neuroplastic mechanisms of
rTMS in stroke rehabilitation, this paper provides a scoping review of recent studies,
which investigate the alteration of brain activity using fMRI after the application of
rTMS over the primary motor area (M1) in movement disorders patients after stroke.
Method The database PubMed, Embase, Web of Science, WanFang Chinese
database, ZhiWang Chinese database from establishment of each database until
December 2022 were included. Two researchers independently screened the literature,
extracted the data and the most relevant features extracted to a summary table. Two
researchers also assessed the methodological quality with the Downs and Black criteria.
Results A total of 711 studies were found in the databases, and 9 were finally
enrolled. They were of good quality or fair quality. The literature mainly involved thetherapeutic effect and imaging mechanisms of rTMS on improving movement disorders
after stroke. In the real rTMS group compared with sham group in all trials, the
neuroplastic effect of rTMS can lead to better functional connectivity in the brain
network in assisting stroke recovery.
Conclusion rTMS allows the excitation and synchronization of neural activity,
changes the functional connectivity between brain regions after stroke, promotes the
reorganization of brain function, and achieves the motor function recovery. fMRI can
observe the influence of rTMS on brain networks and reveal the neuroplasticity
mechanism of post-stroke rehabilitation. The biphasic recovery model of the
transcallosal suppression model and the compensatory model may be the
neurophysiological basis of functional recovery after stroke