Details

Autor(en) / Beteiligte

• Talelli, Penelope
• Wallace, Amanda
• Dileone, Michelle
• Hoad, Damon
• Cheeran, Binith
• Oliver, Rupert
• VandenBos, Mehdi
• Hammerbeck, Ulrike
• Barratt, Karen
• Gillini, Cecilia
• Musumeci, Gabriella
• Boudrias, Marie-Hélène
• Cloud, Geoffrey C.
• Ball, Joanna
• Marsden, Jonathan F.
• Ward, Nicholas S.
• Di Lazzaro, Vincenzo
• Greenwood, Richard G.
• Rothwell, John C.

Titel

Theta Burst Stimulation in the Rehabilitation of the Upper Limb: A Semirandomized, Placebo-Controlled Trial in Chronic Stroke Patients

Ist Teil von

• Neurorehabilitation and neural repair, 2012-10, Vol.26 (8), p.976-987

Ort / Verlag

Los Angeles, CA: SAGE Publications

Erscheinungsjahr

2012

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background. Noninvasive cortical stimulation could represent an add-on treatment to enhance motor recovery after stroke. However, its clinical value, including anticipated size and duration of the treatment effects, remains largely unknown. Objective. The authors designed a small semi-randomized clinical trial to explore whether long-lasting clinically important gains can be achieved by adding theta burst stimulation (TBS), a form of repetitive transcranial magnetic stimulation (TMS), to a rehabilitation program for the hand. Methods. A total of 41 chronic stroke patients received excitatory TBS to the ipsilesional hemisphere or inhibitory TBS to the contralesional hemisphere in 2 centers; each active group was compared with a group receiving sham TBS. TBS was followed by physical therapy for 10 working days. Patients and therapists were blinded to the type of TBS. Primary outcome measures (9-hole Peg Test [9HPT], Jebsen Taylor Test [JTT], and grip and pinch-grip dynamometry) were assessed 4, 30, and 90 days post treatment. The clinically important difference was defined as 10% of the maximum score. Results. There were no differences between the active treatment and sham groups in any of the outcome measures. All patients achieved small sustainable improvements—9HPT, 5% of maximum (confidence interval [CI] = 3%-7%); JTT, 5.7% (CI = 3%-8%); and grip strength, 6% (CI = 2%-10%)—all below the defined clinically important level. Conclusions. Cortical stimulation did not augment the gains from a late rehabilitation program. The effect size anticipated by the authors was overestimated. These results can improve the design of future work on therapeutic uses of TMS.