The effectiveness of intermittent theta burst stimulation for upper limb motor recovery after stroke: an exploratory randomized controlled trial

Didn't your competent? doctor create a protocol on this years ago? NO? 

So, you DON'T HAVE A FUNCTIONING STROKE DOCTOR, do you?

iTBS (13 posts to April 2016)

 The effectiveness of intermittent theta burst stimulation for upper limb motor recovery after stroke: an exploratory randomized controlled trial

Songbin Chen^1,2†Xiaotong Li^2†Wenqing Yang^2,3Guiyuan Cai²Shunxi Zhang²Yujie Chen²Wenyu Chen²Frank Kulwa¹Huangjie Huang⁴Lanfang Xie¹Lingling Tian¹Yangkang Zeng¹Hai Li^1,5*

• ¹Neurorehabilitation Laboratory, Department of Rehabilitation Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China
• ²Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
• ³Clinical School of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
• ⁴Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
• ⁵Guangdong Provincial Key Lab of Robotics and Intelligent System, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China

Background: Stroke often results in significant motor impairments, particularly in the upper limbs, which can severely impact functional independence and quality of life. Conventional rehabilitation methods provide limited recovery, necessitating the exploration of adjunctive therapies to enhance motor function. Intermittent theta burst stimulation (iTBS) is a brain stimulation technique that has shown promise in improving motor function after stroke. This study was conducted to investigate whether iTBS targeting ipsilesional primary motor cortex can induce improvements of the paretic upper limb and physiological changes in cortical excitability in subacute stroke patients.

Methods: 50 patients were randomized assigned to either iTBS or sham stimulation across 10 sessions. Motor function, symptom severity, muscle tone, and functional independence were evaluated. Additional measures included rest motor threshold (RMT), oxygenated hemoglobin concentration.

Results: Both the iTBS and sham groups showed significant improvements in National Institutes of Health Stroke Scale (NIHSS) (iTBS: p = 0.002; sham: p = 0.039), Fugl-Meyer Assessment (FMA) (iTBS: p < 0.001; sham: p = 0.005), and Modified Barthel Index (MBI) (iTBS: p < 0.001; sham: p = 0.002) scores post-intervention. Only the iTBS group demonstrated significant improvements in Modified Ashworth Scale (MAS) (p < 0.001), Wolf Motor Function Test (WMFT) (p < 0.001), and RMT (p = 0.016). The iTBS group exhibited a trend toward greater improvements in MAS (p = 0.001), WMFT (p = 0.002), and MBI (p < 0.001). RMT in contralateral Primary motor cortex (M1) was significantly lower in the iTBS group (p = 0.016), and functional connectivity between each M1 regions was notably enhanced (p = 0.049).

Conclusion: These findings suggest that iTBS may offer additional benefits in improving functional task performance and cortical connectivity in subacute stroke patients.

Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=193454, Identifier ChiCTR2300072415.