Does rTMS Targeting Contralesional S1 Enhance Upper Limb Somatosensory Function in Chronic Stroke? A Proof-of-Principle Study

作者：Svetlana Pundik, Margaret Skelly, Jessica McCabe, Heba Akbari, Curtis Tatsuoka, Ela B. Plow · 发表于：Neurorehabilitation and neural repair · 年份：2021 · DOI：10.1177/1545968321989338 · 被引用次数：15 · 研究领域：Transcranial Magnetic Stimulation Studies、Stroke Rehabilitation and Recovery、Spatial Neglect and Hemispheric Dysfunction

Background Somatosensory deficits are prevalent after stroke, but effective interventions are limited. Brain stimulation of the contralesional primary somatosensory cortex (S1) is a promising adjunct to peripherally administered rehabilitation therapies. Objective To assess short-term effects of repetitive transcranial magnetic stimulation (rTMS) targeting contralesional (S1) of the upper extremity. Methods Using a single-session randomized crossover design, stroke survivors with upper extremity somatosensory loss participated in 3 rTMS treatments targeting contralesional S1: Sham, 5 Hz, and 1 Hz. rTMS was delivered concurrently with peripheral of sensory electrical stimulation and vibration of the affected hand. Outcomes included 2-point discrimination (2PD), proprioception, vibration perception threshold, monofilament threshold (size), and somatosensory evoked potential (SEP). Measures were collected before, immediately after treatment, and 1 hour after treatment. Mixed models were fit to analyze the effects of the 3 interventions. Results Subjects were 59.8 ± 8.1 years old and 45 ± 39 months poststroke. There was improvement in 2PD after 5-Hz rTMS for the stroke-affected ( F(2, 76.163) = 3.5, P = .035) and unaffected arm ( F(2, 192.786) = 10.6, P < .0001). Peak-to-peak SEP amplitudes were greater after 5-Hz rTMS for N33-P45 ( F(2, 133.027) = 3.518, P = .032) and N45-P60 ( F(2, 67.353) = 3.212, P = .047). Latencies shortened after 5-Hz rTMS for N20 ( F(2, 69.64) = 3.37, ...