Ipsilesional 5 Hz Repetitive Transcranial Magnetic Stimulation for Motor Dysfunction in Subacute Intracerebral Hemorrhage: An Exploratory Trial

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation Pub Date : 2025-03-01 DOI:10.1016/j.arrct.2024.100386

Juan Xiao MD , Yan Sun MD , Ze-Jian Liu PT, Bsc , Liang Wu MD, PhD , Weijiao Fan MD , An-Ming Hu MD, PhD

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引用次数: 0

Abstract

Objective

To explore whether ipsilesional 5 Hz repetitive transcranial magnetic stimulation (rTMS) therapy can improve motor function in patients with intracerebral hemorrhage (ICH) and observe any adverse reactions.

Design

A 4-week randomized, controlled, single-blind (evaluator) trial with a 1-month follow-up.

Setting

A tertiary hospital rehabilitation center.

Participants

Forty-nine patients with first ICH were recruited and randomly separated into an experimental (n=25; 19 men, 6 women) or control group (n=24; 17 men, 7 women), with age range of 30 to 75 years, and mean duration after hemorrhage onset of 47 (range 17-86) days.

Interventions

The experimental group received ipsilesional 5 Hz rTMS therapy and conventional rehabilitation training. The hot spot of the abductor pollicis brevis and tibialis anterior muscles on the affected hemisphere of the brain received 1500 pulses of stimulation each day, for a total of 3000 pulses. The stimulations applied to the affected abductor pollicis brevis and tibialis anterior hot spots were separated by >2 hours. The stimulation frequency was 5 Hz, each sequence lasting 2 seconds, with a sequence interval of 5 seconds, for a total duration of 36 minutes every day. The control group only received conventional rehabilitation training.

Main Outcome Measures

The primary endpoint was the change in Brunnstrom stage. Secondary endpoints included Fugl-Meyer Assessment, Barthel Index, and Berg Balance Scale. All assessments were performed at baseline, after intervention (day 29) and 1 month after intervention (day 60).

Results

Improvements over baseline in all scores at day 29 and 60 were significantly greater in the 5 Hz rTMS group than in the control group. No significant side effects were reported during the experiment and 1 month after the experiment.

Conclusions

Applying 5 Hz high-frequency rTMS to the affected hemisphere within 3 months after the onset of ICH appears safe and may significantly improve motor function and activities of daily living.

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单侧5hz重复经颅磁刺激治疗亚急性脑出血患者的运动功能障碍：一项探索性试验

目的探讨同侧5hz重复经颅磁刺激（rTMS）治疗脑出血（ICH）患者的运动功能是否得到改善，并观察其不良反应。DesignA为期4周的随机、对照、单盲（评估者）试验，随访1个月。三级医院康复中心。参与者招募49例首发脑出血患者，随机分为实验组(n=25；男性19例，女性6例)或对照组(n=24；男性17例，女性7例)，年龄30 ~ 75岁，出血后平均持续时间47天（17 ~ 86天）。干预措施实验组患者接受同期5hz rTMS治疗和常规康复训练。对患脑半球的拇短外展肌和胫前肌热点每天进行1500次脉冲刺激，共计3000次脉冲。对受累拇短外展肌和胫骨前肌热点的刺激间隔2小时。刺激频率为5 Hz，每个序列持续2秒，序列间隔5秒，每天总持续时间36分钟。对照组仅接受常规康复训练。主要终点为Brunnstrom期的变化。次要终点包括Fugl-Meyer评估、Barthel指数和Berg平衡量表。所有评估均在基线、干预后（第29天）和干预后1个月（第60天）进行。结果5 Hz rTMS组在第29天和第60天的各项评分较基线的改善均显著高于对照组。实验期间及实验后1个月无明显副作用。结论脑出血发病后3个月内对患脑半球应用5hz高频rTMS是安全的，可显著改善运动功能和日常生活能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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