Deans' stroke musings: Combining Theta Burst Stimulation With Training After Subcortical Stroke

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.

Friday, September 20, 2019

Combining Theta Burst Stimulation With Training After Subcortical Stroke

You'll have to ask your doctor what the protocol is and if your hospital has machines that can deliver TBS. Whereas this research from February 2013 showed no benefit; Ask your doctor to reconcile these two.

Theta burst stimulation in the rehabilitation of the upper limb: A semirandomized, placebo-controlled trial in chronic stroke patients

February 2013

The latest here:

Combining Theta Burst Stimulation With Training After Subcortical Stroke

Suzanne J. Ackerley, BPHTY; Cathy M. Stinear, PhD;P. Alan Barber, FRACP; Winston D. Byblow, PhD
Background Purpose
Repetitive transcranial magnetic stimulation of the primary motor cortex (M1) may improve outcomes after stroke. The aim of this study was to determine the effects of M1 theta burst stimulation (TBS) and standardized motor training on upper-limb function of patients with chronic stroke.
Methods
Ten patients with chronic subcortical stroke and upper-limb impairment were recruited to this double-blind,crossover, sham-controlled study. Intermittent TBS of the ipsilesional M1, continuous TBS of the contralesional M1,and sham TBS were delivered in separate sessions in conjunction with standardized training of a precision grip task using the paretic upper limb.
Results
Training after real TBS improved paretic-hand grip-lift kinetics, whereas training after sham TBS resulted indeterioration of grip-lift. Ipsilesional M1 excitability increased after intermittent TBS of the ipsilesional M1 but decreased after continuous TBS of the contralesional M1. Action Research Arm Test scores deteriorated when training followed continuous TBS of the contralesional M1, and this was correlated with reduced ipsilesional corticomotor excitability.
Conclusions
Generally, TBS and training led to task-specific improvements in grip-lift. Specifically, continuous TBS of the contralesional M1 led to an overall decrement in upper-limb function, indicating that the contralesional hemisphere may play a pivotal role in recovery after stroke. ( Stroke . 2010;41:1568-1572.)