Effects of Repetitive Transcranial Magnetic Stimulation on Electroencephalographic Activity, Lower-Limb Muscle Activation, and Balance in Patients with Stroke.
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引用次数: 0
Abstract
Background: Repetitive transcranial magnetic stimulation (rTMS) is increasingly used as a neuromodulatory intervention to facilitate motor recovery after stroke. However, the frequency-specific effects of rTMS on lower-limb motor control and their neurophysiological correlates remain insufficiently clarified.
Objective: To compare the effects of low-frequency (1 Hz) rTMS applied over the contralesional (unaffected) lower-limb motor area of the primary motor cortex and high-frequency (10 Hz) rTMS applied over the ipsilesional (affected) lower-limb motor area on electroencephalographic (EEG) activity, affected-side lower-limb muscle activation, balance, and gait in individuals with chronic stroke.
Methods: Thirty-nine participants with chronic stroke were randomly assigned to a low-frequency rTMS group (n = 13), a high-frequency rTMS group (n = 13), or a sham group (n = 13). rTMS was delivered for 10 sessions over 2 weeks. Resting-state EEG (relative beta-band power at Cz), surface EMG of the affected-side rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius during sit-to-stand, Timed Up and Go (TUG), 10-meter walk test (10MWT), and limits of stability (LOS) were assessed before and after the intervention. A 3 × 2 mixed-design analysis of variance (ANOVA) (group × time) was conducted.
Results: Significant group × time interactions were observed for rectus femoris activation (p < 0.001) and TUG performance (p = 0.037). Post hoc pairwise comparisons confirmed significantly greater improvements in TUG performance and rectus femoris activation in the low-frequency rTMS group than in the high-frequency and sham groups. Relative beta-band activity at Cz demonstrated a significant main effect of time (p < 0.001) without a significant interaction effect. Similarly, 10MWT and LOS showed significant time effects (p < 0.05) but no significant group × time interactions. No significant main effects of group were identified across outcomes.
Conclusion: Short-term rTMS was associated with improvements in selected neuromuscular outcomes, while changes in resting cortical activity, gait speed, and postural stability appeared to reflect general time-related effects. Low-frequency rTMS demonstrated greater improvements in rectus femoris activation and TUG performance compared with high-frequency and sham stimulation. These findings suggest that frequency-specific rTMS may preferentially influence neuromuscular strategies underlying dynamic mobility rather than steady-state gait performance.
期刊介绍：
This interdisciplinary journal publishes papers relating to the plasticity and response of the nervous system to accidental or experimental injuries and their interventions, transplantation, neurodegenerative disorders and experimental strategies to improve regeneration or functional recovery and rehabilitation. Experimental and clinical research papers adopting fresh conceptual approaches are encouraged. The overriding criteria for publication are novelty, significant experimental or clinical relevance and interest to a multidisciplinary audience. Experiments on un-anesthetized animals should conform with the standards for the use of laboratory animals as established by the Institute of Laboratory Animal Resources, US National Academy of Sciences. Experiments in which paralytic agents are used must be justified. Patient identity should be concealed. All manuscripts are sent out for blind peer review to editorial board members or outside reviewers. Restorative Neurology and Neuroscience is a member of Neuroscience Peer Review Consortium.
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