Immediate Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation to Augment Task-Specific Training in Sub-acute Stroke

The current study examined the immediate effects of a single-session low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) with task-specific training in sub-acute stroke. Sixteen participants were randomly received either active LF-rTMS (experimental group) over the non-lesioned hemisphere or sham stimulation (control group). Consequently, both groups underwent task-specific training with the paretic hand and constrained the non-paretic hand by a mitt for 1 hour. The authors evaluated the corticospinal excitability of the non-lesioned hemisphere (evaluated by motor evoked potential (MEP) amplitude) and the behavioral outcomes of both hands (evaluated by total movement time (TMT) of the Wolf Motor Function Test). There were significant differences between the two groups in the MEP amplitude of the non-lesioned hemisphere at post LF-rTMS and post motor training. Comparing to that of the baseline, the experimental group showed a greater decrease in TMT of the paretic hand immediately after active LF-rTMS than the control group. Additionally, the TMT of experimental group further decreased after the motor training and it was significantly less than that of the control group. Therefore, the task-specific training effect was augmented by LF-rTMS to improve the performance of paretic hand in sub-acute stroke.