on May 4, 2006
Published online before print May 4, 2006, doi: 10.1161/01.STR.0000221233.55497.51
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on December 25, 2005
From the Department of Physical Medicine and Rehabilitation, Stroke and Cerebrovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (Y.H.K.); Hampton University, Doctor of Physical Therapy Program, Hampton, Va (S.H.Y.); Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea (M.H.K.); Department of Physical Therapy, College of Health Science, Catholic University of Daegu, Daegu, Republic of Korea (J.W.P.); Department of Neurology, Stroke and Cerebrovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.H.L.); Department of Physical Medicine and Rehabilitation, School of Medicine, Yeungnam University, Daegu, Republic of Korea (S.H.J.); Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Dongan-ku, Anyang, Republic of Korea (W.K.Y.); and National Institute of Neurological Disorders and Stroke, Human Motor Control Section, National Institutes of Health, Medical Neurology Branch, Bethesda, Md (M.H.). * To whom correspondence should be addressed. E-mail: yunkim{at}smc.samsung.co.kr.
Background and Purpose--Although there is some early evidence showing the value of repetitive transcranial magnetic stimulation (rTMS) in stroke rehabilitation, the therapeutic effect of high-frequency rTMS, along with the physiology of rTMS-induced corticomotor excitability supporting motor learning in stroke, has not been established. This study investigated high-frequency rTMS-induced cortical excitability and the associated motor skill acquisition in chronic stroke patients. Methods--Fifteen patients with chronic hemiparetic stroke (13 men; mean age 53.5 years) practiced a complex, sequential finger motor task using their paretic fingers either after 10 Hz or sham rTMS over the contralateral primary motor cortex (M1). Both the changes in the behavior and corticomotor excitability before and after the intervention were examined by measuring the movement accuracy, the movement time, and the motor-evoked potential (MEP) amplitude. A separate repeated-measures ANOVA and correlation statistics were used to determine the main and interaction effects as well as relationship between the changes in the behavioral and corticomotor excitability. Results--High-frequency rTMS resulted in a significantly larger increase in the MEP amplitude than the sham rTMS (P<0.01), and the plastic change was positively associated with an enhanced motor performance accuracy (P<0.05). Conclusions--High-frequency rTMS of the affected motor cortex can facilitate practice-dependent plasticity and improve the motor learning performance in chronic stroke victims.
Revised on February 10, 2006
Accepted on March 21, 2006
Repetitive Transcranial Magnetic Stimulation-Induced Corticomotor Excitability and Associated Motor Skill Acquisition in Chronic Stroke
Yun-Hee Kim MD, PhD*;
Key words: motor activity • stroke • transcranial magnetic stimulation
This article has been cited by other articles:
 |
|
 |
|
  R. Sparing, M. Thimm, M. D. Hesse, J. Kust, H. Karbe, and G. R. Fink Bidirectional alterations of interhemispheric parietal balance by non-invasive cortical stimulation Brain, November 1, 2009; 132(11): 3011 - 3020. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Koganemaru, T. Mima, M. Nakatsuka, Y. Ueki, H. Fukuyama, and K. Domen Human motor associative plasticity induced by paired bihemispheric stimulation J. Physiol., October 1, 2009; 587(19): 4629 - 4644. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Nowak, C. Grefkes, M. Ameli, and G. R. Fink Interhemispheric Competition After Stroke: Brain Stimulation to Enhance Recovery of Function of the Affected Hand Neurorehabil Neural Repair, September 1, 2009; 23(7): 641 - 656. [Abstract] [PDF]
|
|
|
|
|
|
E. Castel-Lacanal, P. Marque, J. Tardy, X. de Boissezon, V. Guiraud, F. Chollet, I. Loubinoux, and M. Simonetta-Moreau Induction of Cortical Plastic Changes in Wrist Muscles by Paired Associative Stimulation in the Recovery Phase of Stroke Patients Neurorehabil Neural Repair, May 1, 2009; 23(4): 366 - 372. [Abstract] [PDF]
|
|
|
|
 |
|
 E. B. Plow, J. R. Carey, R. J. Nudo, and A. Pascual-Leone Invasive Cortical Stimulation to Promote Recovery of Function After Stroke: A Critical Appraisal Stroke, May 1, 2009; 40(5): 1926 - 1931. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Harvey, C. J. Winstein, and for the Everest Trial Group Design for the Everest Randomized Trial of Cortical Stimulation and Rehabilitation for Arm Function Following Stroke Neurorehabil Neural Repair, January 1, 2009; 23(1): 32 - 44. [Abstract] [PDF]
|
|
|
|
|
|
N. Yozbatiran, M. Alonso-Alonso, J. See, A. Demirtas-Tatlidede, D. Luu, R. R. Motiwala, A. Pascual-Leone, and S. C. Cramer Safety and Behavioral Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation in Stroke Stroke, January 1, 2009; 40(1): 309 - 312. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. V. Sale, M. C. Ridding, and M. A. Nordstrom Cortisol Inhibits Neuroplasticity Induction in Human Motor Cortex J. Neurosci., August 13, 2008; 28(33): 8285 - 8293. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Hiscock, S. Miller, J. Rothwell, R. C. Tallis, and V. M. Pomeroy Informing Dose-Finding Studies of Repetitive Transcranial Magnetic Stimulation to Enhance Motor Function: A Qualitative Systematic Review Neurorehabil Neural Repair, June 1, 2008; 22(3): 228 - 249. [Abstract] [PDF]
|
|
|
|
 |
|
 J Duque, R Mazzocchio, K Stefan, F Hummel, E Olivier, and L. G. Cohen Memory Formation in the Motor Cortex Ipsilateral to a Training Hand Cereb Cortex, June 1, 2008; 18(6): 1395 - 1406. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. D. Roy, J. A. Norton, and M. A. Gorassini Role of Sustained Excitability of the Leg Motor Cortex After Transcranial Magnetic Stimulation in Associative Plasticity J Neurophysiol, August 1, 2007; 98(2): 657 - 667. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Hotermans, P. Peigneux, G. Moonen, A. Maertens de Noordhout, and P. Maquet Therapeutic Use of High-Frequency Repetitive Transcranial Magnetic Stimulation in Stroke Stroke, February 1, 2007; 38(2): 253 - 253. [Full Text] [PDF]
|
|
|
|
|
|
V. Di Lazzaro, M. Dileone, P. Profice, F. Pilato, B. Cioni, M. Meglio, F. Capone, P. A. Tonali, and J. C. Rothwell Direct Demonstration That Repetitive Transcranial Magnetic Stimulation Can Enhance Corticospinal Excitability in Stroke Stroke, November 1, 2006; 37(11): 2850 - 2853. [Abstract] [Full Text] [PDF]
|
|