Cortical and spinal excitability changes after repetitive transcranial magnetic stimulation combined to physiotherapy in stroke spastic patients

被引：42

作者：

Costa dos Santos, Rebeka Borba ^{[1
]}

Barros Galvao, Silvana Carla ^{[1
]}

Pinel Frederico, Labibe Mara ^{[1
]}

Lucena Amaral, Nathalia Serrano ^{[1
]}

Souza Carneiro, Maira Izzadora ^{[1
]}

de Moura Filho, Alberto Galvao ^{[2
]}

Piscitelli, Daniele ^{[3
]}

Monte-Silva, Katia ^{[1
]}

机构：

[1] Univ Fed Pernambuco, Appl Neurosci Lab, Dept Phys Therapy, Ave Jornalista Anibal Fernandes S-N, BR-50740560 Recife, PE, Brazil

[2] Univ Fed Pernambuco, Lab Kinesiol & Funct Assessment, Dept Phys Therapy, Ave Jornalista Anibal Fernandes S-N, BR-50740560 Recife, PE, Brazil

[3] McGill Univ, Sch Phys & Occupat Therapy, Montreal, PQ, Canada

来源：

NEUROLOGICAL SCIENCES | 2019年 / 40卷 / 06期

关键词：

Transcranial magnetic stimulation; Muscle spasticity; Upper extremity; H-reflex; Stroke; Physical therapy; LOWER-EXTREMITY SPASTICITY; PRIMARY MOTOR CORTEX; PHYSICAL-THERAPY; PLASTICITY; HAND; PATHOPHYSIOLOGY; INDUCTION; STRENGTH; REVERSAL; OUTCOMES;

D O I：

10.1007/s10072-019-03765-y

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

ObjectiveRepetitive Transcranial Magnetic Stimulation (rTMS) has been used to treat post-stroke upper limb spasticity (ULS) in addition to physiotherapy (PT). To determine whether rTMS associated with PT modulates cortical and spinal cord excitability as well as decreases ULS of post-stroke patients.MethodsTwenty chronic patients were randomly assigned to either the intervention group-1Hz rTMS on the unaffected hemisphere and PT, or control group-sham stimulation and PT, for ten sessions. Before and after sessions, ULS was measured using the modified Ashworth scale and cortical excitability using the output intensity of the magnetic stimulator (MSO). The spinal excitability was measured by the Hmax/Mmax ratio of the median nerve at baseline, at the end of treatment, and at the 4-week follow-up.ResultsThe experimental group showed at the end of treatment an enhancement of cortical excitability, i.e., lower values of MSO, compared to control group (p=0.044) and to baseline (p=0.028). The experimental group showed a decreased spinal cord excitability at the 4-week follow-up compared to control group (p=0.021). ULS decreased by the sixth session in the experimental group (p<0.05).ConclusionOne-hertz rTMS associated with PT increased the unaffected hemisphere excitability, decreased spinal excitability, and reduced post-stroke ULS.

引用

页码：1199 / 1207

页数：9

共 40 条

[1]

The relation between Ashworth scale scores and the excitability of the α motor neurones in patients with post-stroke muscle spasticity [J].