Application of non-invasive brain stimulation combined with functional magnetic resonance imaging in post-stroke motor function rehabilitation.

Background: Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising non-invasive brain stimulation (NIBS) system for post-stroke motor rehabilitation. However, its underlying mechanisms are still not well understood.

New method: In this research, 170 post-stroke patients with motor impairments were randomly divided into an rTMS intervention group (n = 85) and a control group (n = 85). Along with routine motor rehabilitation exercises, the rTMS group received 30minutes of 5Hz rTMS over the left Dorsolateral Prefrontal Cortex (DPC) three times a week for 30 days. Sham rTMS treatment can be allocated to the control group. Resting-state functional magnetic resonance imaging (rs-fMRI) was used to evaluate brain activity and functional connectivity (FC) in motor-related areas.

Results: Both the intervention and control groups showed significant motor function improvements, but the rTMS group had more substantial gains. In the intervention group, FCA values in motor regions such as the primary motor cortex (PMC) and Precentral Gyrus (PCG) improved. There was also an increase in FC between the DPC and motor areas.

Comparison with existing methods: Unlike some previous studies that may have focused only on motor function improvement without in-depth exploration of brain activity and connectivity changes, this study used rs-fMRI to comprehensively analyze the cerebral functional alterations induced by rTMS, providing a more detailed understanding of the underlying mechanisms of rTMS in post-stroke rehabilitation.

Conclusions: The findings suggest that rTMS promotes motor recovery in post-stroke patients by modulating brain activity and connectivity within motor networks.