Effect of Different Frequencies of Repetitive Transcranial Magnetic Stimulation on Motor Function Recovery after Acute Ischemic Stroke

Background and Purpose: Although there is some early evidence showing the value of repetitive transcranial magnetic stimulation (rTMS) in stroke rehabilitation, the therapeutic effect of high-frequency rTMS, has not been established. The aim of this study is to investigate the effect of different frequencies of rTMS on motor cortical excitability on the affected and non affected hemisphere and to detect the best frequency used to enhance motor recovery in acute stroke patients. Methods: Forty eight patients with acute ischemic stroke of middle cerebral artery territory participated in the study (24) males and (24) females. The patients were randomly classified into three groups: Group 1 (included sixteen patients who received real rTMS with 3Hz). Group 2 (included sixteen patients who received real rTMS with 10 Hz). Group 3 (included sixteen patients who received sham rTMS with 3 Hz) for five consecutive days. Otherwise, patients continued their medical treatment. Each patient underwent complete neurological examination, CT and/or MRI of the brain, motor disability and functional ability, EEG and neurophysiological assessment before and after rTMS sessions. Results: There was significant improvement in patients who received real rTMS in comparison to the sham rTMS group regarding motor power recovery and all stroke scales scores. The improvement was concomitantly associated with cortical excitability changes. Conclusions: High-frequency rTMS provides a fast, effective, painless, non invasive treatment for motor disorders during the rehabilitation of acute stroke patients. (Egypt J. Neurol. Psychiat. Neurosurg., 2008, 45(2): 469-481)