Early continuous theta-burst stimulation of the contralesional motor cortex promotes upper limb recovery after stroke, which is accompanied by an increase in motor-eloquent area size (B-STARS): a randomised controlled trial

Abstract Introduction: Despite advances in acute stroke therapies and rehabilitation strategies, many patients are left with long-term upper limb motor impairment. In a randomized controlled trial, we assessed whether continuous theta-burst stimulation (cTBS) of the contralesional cortex combined regular care therapy delivered within three weeks after onset promoted recovery. addition, investigated treatment effects were associated longitudinal changes motor-eloquent area (MEA) organisation. Methods: We randomly assigned unilateral impairment to ten daily sessions active or sham cTBS. Treatment was started directly followed by therapy. The primary outcome change Action Research Arm Test (ARAT) score, measure activity, at months post-stroke. Secondary outcomes included score on modified Rankin Scale (mRS) MEA size, measured TMS-electromyography mapping until one-year Results: randomised 60 patients, whom 29 31 cTBS cTBS, respectively. mean difference ARAT from baseline post-stroke 9.5 points (p=0.024) favour Active better scores mRS (odds ratio 0.2; p=0.023). Ipsilesional size significantly increased who received compared across all visits (mean 2.1; p=0.018). Conclusion: Ten M1 training, onset, promote recovery reduces disability dependence. expansion may be mode action promotion stroke. Category Technology Methods Clinical Research: 10. Transcranial Magnetic Stimulation (TMS) Keywords: Stroke, Upper recovery, repetitive transcranial magnetic stimulation, theta burst