1. Factors influencing the response to high-frequency repetitive transcranial magnetic stimulation in patients with subacute stroke
- Author
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Yun-Hee Kim, Alvaro Pascual-Leone, Kyeong Eun Uhm, Yong-Il Shin, and Won Hyuk Chang
- Subjects
Adult ,Male ,030506 rehabilitation ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Motor Activity ,Logistic regression ,Upper Extremity ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Developmental Neuroscience ,Neurotrophic factors ,Outcome Assessment, Health Care ,medicine ,Humans ,Prospective Studies ,Deep transcranial magnetic stimulation ,Stroke ,Aged ,Aged, 80 and over ,business.industry ,Stroke Rehabilitation ,Middle Aged ,Evoked Potentials, Motor ,medicine.disease ,Transcranial Magnetic Stimulation ,Transcranial magnetic stimulation ,Treatment Outcome ,medicine.anatomical_structure ,Neurology ,Corticospinal tract ,Physical therapy ,Upper limb ,Female ,Neurology (clinical) ,Primary motor cortex ,0305 other medical science ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND AND PURPOSE High-frequency repetitive transcranial magnetic stimulation (rTMS) aids motor recovery in patients with subacute stroke. However, the response to high-frequency rTMS is highly variable between patients. The aim of this study was to identify the factors associated with improved motor function in response to high-frequency rTMS in subacute stroke patients with moderate to severe upper extremity motor involvement. METHODS Sixty-two patients with subacute stroke were enrolled. rTMS was applied over the primary motor cortex of the affected hemisphere at 10 Hz with 1,000 pulses/day for 10 days. Upper limb motor function was scored with the upper limb of Fugl-Meyer Assessment (FMA-UL) score before intervention and immediately after intervention. All FMA-UL changes greater than or equal to 5 points were considered clinically significant. Potential influencing factors considered included patient characteristics, motor function, corticospinal tract (CST) integrity assessments, and genetics. Multivariate logistic regression analysis was used to identify the significance of each of these factors. RESULTS We found that the two factors with the greatest impact on the improvement in FMA-UL score were: 1) the functional integrity of the CST, and 2) the brain-derived neurotrophic factor (BDNF) genotype (p
- Published
- 2016