Article

OBJECTIVE: To determine the impact of a single-session of repetitive transcranial
magnetic stimulation (rTMS) and an rTMS intervention on neurophysiology and motor
control in survivors of stroke. METHODS: Twelve stroke survivors were randomized
into functional-rTMS or passive-rTMS conditions. Measures of short-interval
intracortical inhibition (SICI) and intracortical facilitation (ICF), and force
steadiness (coefficient of variation, CV) at 10 and 20% of maximum voluntary
contraction were assessed at baseline and after a single-session of rTMS (post
single-session), and again following an intervention of 8 rTMS sessions (2
sessions per day; post-intervention). Functional-rTMS required subjects to exceed
a muscle activation threshold assessed by surface electromyography to trigger
each rTMS train; the passive-rTMS group received rTMS while relaxed. RESULTS: ICF
scores significantly increased following the single-session of functional-rTMS
compared to the decrease following passive-rTMS. The increase in APB SICI and ICF
scores following the intervention was significantly greater for the
functional-rTMS group compared to the decreases following passive-rTMS. The
groups were significantly different in the CV of force (20%) following the
single-session of rTMS, and in the 10 and 20% tasks following the intervention.
The functional-rTMS group increased steadiness overtime, whereas the passive
group demonstrated a return to baseline following the intervention session. No
differences were observed in first dorsal interosseus (FDI) measures (SICI and
ICF) between groups. CONCLUSIONS: The functional-rTMS protocol enhanced cortical
excitability following a single-session and after repeated sessions and improved
steadiness, whereas the passive stimulation protocol tended to decrease
excitation and no improvements in steadiness were observed.

Langue : ANGLAIS