Behavioral and neuroplastic effects of low-frequency rTMS of the unaffected hemisphere in a chronic stroke patient: a concomitant TMS and fMRI study

Neurocase. 2014;20(6):615-26. doi: 10.1080/13554794.2013.826691. Epub 2013 Aug 21.

Abstract

Repetitive Transcranial Magnetic Stimulation (rTMS) ameliorates motor and neuropsychological deficits following stroke, but little is known about the underlying neuroplasticity. We investigated neuroplastic changes following 5 days of low-frequency rTMS on the intact motor cortex to promote motor recovery in a chronic patient with subcortical stroke. The feasibility of administering multiple treatments was also assessed 6 months later by applying the same protocol over the patient's parietal cortex to improve visuospatial disorders. Behavioral improvements and no adverse events were observed. Neuroimaging findings indicated that motor symptoms amelioration was associated with downregulation and cortical reorganization of hyperactive contralesional hemisphere.

Keywords: Functional MRI; Motor recovery; Stroke; Visual attention; rTMS.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Mapping
  • Chronic Disease
  • Diffusion Tensor Imaging
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Motor Activity / physiology*
  • Motor Cortex / physiopathology*
  • Neuronal Plasticity / physiology*
  • Parietal Lobe / physiopathology
  • Stroke / complications
  • Stroke / physiopathology*
  • Stroke / therapy*
  • Transcranial Magnetic Stimulation*
  • Visual Fields / physiology*