CLINICAL TRIAL article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1683552
This article is part of the Research TopicNon-Invasive Brain Stimulation: From Basic Science to Clinical ApplicationView all 3 articles
Effects of different magnetic stimulation paradigms on post-stroke upper limb function: A randomized controlled trial
Provisionally accepted
- Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
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ABSTRACT: Background: Current evidence suggests that repetitive transcranial magnetic stimulation (rTMS), repetitive peripheral magnetic stimulation (rPMS), and their combined application can all enhance upper limb functional recovery after stroke. However, their comparative therapeutic profiles, including relative advantages and limitations, have not been systematically characterized. Objectives: To compare rTMS, rPMS, and combined protocols for post-stroke upper limb recovery, analyzing both functional outcomes and neural mechanisms to guide therapeutic selection. Methods: Fifty-one stroke patients were randomly divided into rTMS group, rPMS group and the combined group. Before and after 3 weeks of intervention, all patients were assessed with the Fugl-Meyer assessment for the upper limb (FMA-UL), the Thumb Localizing Test (TLT), modified Barthel index (MBI), and resting-state functional magnetic resonance imaging (rs-fMRI). Results: The FMA-UL and MBI scores of the combined group were significantly better than rTMS group and rPMS group. The TLT scores of the combined group and rPMS were significantly better than rTMS group, but there was no statistically significant difference in TLT scores between rPMS and the combined group. Comparing to the rTMS group, the rPMS group showed increased amplitude of low-frequency fluctuation (ALFF) in the ipsilesional superior frontal gyrus, cerebellum_8 area, contralesional cerebellum_crus1; the combined group showed increased ALFF in the ipsilesional cerebellum_8 area, superior medial frontal gyrus, contralesional cerebellum_crus2 area. Compared with the rPMS group, the combined group showed increased ALFF in the ipsilesional paracentral lobule, supplementary motor area, precentral gyrus and superior medial frontal gyrus. Conclusions: Compared with rTMS, rPMS has certain advantages in improving proprioception after stroke, and combination therapy improves both motor and proprioception. Therefore, combination therapy is more recommended to promote the recovery of brain and limb function. Clinical Trial Registration: chictr.org.cn, ChiCTR2200065871.
Keywords: Stroke, Upper limb motor function, repetitive transcranial magnetic stimulation, Repetitive peripheral magnetic stimulation, functional magnetic resonance imaging
Received: 11 Aug 2025; Accepted: 03 Oct 2025.
Copyright: © 2025 Xu, Luo, Huang, Chen, Liu and Cui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wei Cui, cxw0516@163.com
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