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Effects of different magnetic stimulation paradigms on post-stroke upper limb
function: a randomized controlled trial
#MMPMID41180535
Xu L
; Luo H
; Huang L
; Chen S
; Liu H
; Cui W
Front Neurol
2025[]; 16
(?): 1683552
PMID41180535
show ga
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 an rTMS
group, rPMS group, or a 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 the
rTMS group and rPMS group. The ?TLT scores of the combined group and rPMS were
significantly better than the rTMS group, but there was no statistically
significant difference in ?TLT scores between rPMS and the combined group.
Compared to the rTMS group, the rPMS group showed increased amplitude of
low-frequency fluctuation (ALFF) in the ipsilesional superior frontal gyrus,
cerebellum_8 area, and contralesional cerebellum_crus1; the combined group showed
increased ALFF in the ipsilesional cerebellum_8 area, superior medial frontal
gyrus, and 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.
CONCLUSION: Compared with rTMS, rPMS has certain advantages in improving
proprioception after stroke, and combination therapy improves both motor and
proprioception. Therefore, combination therapy is recommended to better promote
the recovery of brain and limb function. CLINICAL TRIAL REGISTRATION:
http://chictr.org.cn, Identifier ChiCTR2200065871.
free
free
free
