Deans' stroke musings: Continuous theta-burst stimulation combined with occupational therapy for upper limb hemiparesis after stroke: a preliminary study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, April 6, 2014

Continuous theta-burst stimulation combined with occupational therapy for upper limb hemiparesis after stroke: a preliminary study

You'll have to ask your OT and doctor what the chances are of you getting this type of therapy.
http://scholar.google.com/scholar_url?hl=en&q=http://link.springer.com/article/10.1007/s13760-014-0294-y&sa=X&scisig=AAGBfm0j7YvI9g2r7jiUKyB-BNXO7n_d4g&oi=scholaralrt
Abstract
The current study investigated the contributions of contralesional primary somatosensory cortex (S1c) to motor learning deficits post-stroke. For three days, continuous theta burst (cTBS) was delivered over the contralesional hemisphere prior to practicing a serial targeting task. cTBS was delivered over either S1c, contralesional primary motor cortex (M1c) or as control stimulation (n=4/group). Change in motor ability was assessed from initial performance to a delayed retention test using a serial targeting task and a subset of items from the Wolf Motor Function Test. Practice preceded by cTBS over either M1c or S1c resulted in large decreases in movement time compared to practice preceded by control stimulation. M1c cTBS resulted in larger decreases in peak velocity and peak acceleration compared to control and S1c cTBS. In contrast, S1c cTBS resulted in larger reductions in time to initiate movement and time to complete the WMFT compared to control and M1c cTBS. These preliminary findings suggest that stimulation of either M1c or S1c can enhance the benefits of practice. However, changes in M1c and S1c excitability may contribute to different aspects of post-stroke motor deficits that may differentially impact rehabilitation.
In patients with subacute right hemispheric ischemic stroke, continuous theta-burst stimulation of intact posterior parietal cortex of the left hemisphere improves hemispatial neglect after two weeks of treatment, according to a study published online.
In patients with subacute right hemispheric (RH) ischemic stroke, continuous theta-burst stimulation (cTBS) of intact posterior parietal cortex (PPC) of the left hemisphere (LH) improves hemispatial neglect after two weeks of treatment.
Giacomo Koch, M.D., Ph.D., from the Santa Lucia Foundation IRCCS in Rome, and colleagues investigated the safety and efficacy of cTBS in patients with subacute RH ischemic stroke in 10 sessions over two weeks. Twenty consecutive patients were randomly allocated to real and sham LH PPC cTBS. A standardized Behavioral Inattention Test (BIT) was used to assess the severity of hemispatial neglect. The effect of cTBS on the excitability of the parieto-frontal functional connections in the intact LH were measured by bifocal transcranial magnetic stimulation.

The investigators found that the neglect symptoms improved after two weeks of real, but not sham, cTBS. In the real cTBS group, the BIT score improved by 16.3 and 22.6 percent after two weeks and at one month of follow-up, respectively. Real, but not sham cTBS, reduced the hyperexcitability of LH parieto-frontal circuits.
"These findings suggest that a two-week course of cTBS over the LH PPC may be a potential effective strategy in accelerating recovery from visuospatial neglect in subacute stroke patients, possibly counteracting the hyperexcitability of LH parieto-frontal circuits," the authors write.