Multifocal transcranial stimulation in chronic ischemic stroke: A phase 1/2a randomized trial.
Brain Ischemia
/ diagnostic imaging
Chronic Disease
Disability Evaluation
Female
Humans
Magnetic Resonance Imaging
Male
Motor Activity
Motor Cortex
/ diagnostic imaging
Recovery of Function
Stroke
/ diagnosis
Texas
Time Factors
Transcranial Magnetic Stimulation
/ adverse effects
Treatment Outcome
Wearable Electronic Devices
Chronic ischemic stroke
Functional magnetic resonance imaging
Neuromodulation
Neuroplasticity
Transcranial magnetic stimulation
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
10
12
2019
revised:
10
02
2020
accepted:
15
03
2020
pubmed:
24
4
2020
medline:
30
9
2020
entrez:
24
4
2020
Statut:
ppublish
Résumé
Repetitive transcranial magnetic stimulation (rTMS) may promote recovery of motor function after stroke by inducing functional reorganization of cortical circuits. The objective of this study was to examine whether multifocal cortical stimulation using a new wearable transcranial rotating permanent magnet stimulator (TRPMS) can promote recovery of motor function after stroke by inducing functional reorganization of cortical circuits. Thirty TRPMS treatment was well-tolerated with no device-related adverse effects. Active treatment produced a significantly greater increase in the number of active voxels on fMRI than sham treatment (median +48.5 vs -30, p = 0.038). The median active voxel number after active treatment was 8.8-fold greater than after sham (227.5 vs 26, p = 0.016). Although the statistical power was inadequate to establish clinical endpoint benefits, numerical improvements were demonstrated in 5 of 6 clinical scales of motor function. The treatment effects persisted over a 3-month duration of follow-up. Multifocal bilateral TRPMS was safe and showed significant fMRI changes suggestive of functional reorganization of cortical circuits in patients with chronic ischemic stroke. A larger randomized clinical trial is warranted to verify recovery of motor function.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Repetitive transcranial magnetic stimulation (rTMS) may promote recovery of motor function after stroke by inducing functional reorganization of cortical circuits. The objective of this study was to examine whether multifocal cortical stimulation using a new wearable transcranial rotating permanent magnet stimulator (TRPMS) can promote recovery of motor function after stroke by inducing functional reorganization of cortical circuits.
METHODS
METHODS
Thirty
RESULTS
RESULTS
TRPMS treatment was well-tolerated with no device-related adverse effects. Active treatment produced a significantly greater increase in the number of active voxels on fMRI than sham treatment (median +48.5 vs -30, p = 0.038). The median active voxel number after active treatment was 8.8-fold greater than after sham (227.5 vs 26, p = 0.016). Although the statistical power was inadequate to establish clinical endpoint benefits, numerical improvements were demonstrated in 5 of 6 clinical scales of motor function. The treatment effects persisted over a 3-month duration of follow-up.
CONCLUSIONS
CONCLUSIONS
Multifocal bilateral TRPMS was safe and showed significant fMRI changes suggestive of functional reorganization of cortical circuits in patients with chronic ischemic stroke. A larger randomized clinical trial is warranted to verify recovery of motor function.
Identifiants
pubmed: 32321651
pii: S1052-3057(20)30200-7
doi: 10.1016/j.jstrokecerebrovasdis.2020.104816
pii:
doi:
Types de publication
Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
104816Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.