Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Noninvasive brain stimulation (NIBS) is a promising technique for improving upper limb motor performance post-stroke. Its application has been guided by the interhemispheric competition model and typically involves suppression of contralesional motor cortex. However, the bimodal balance recovery model prompts a more tailored application of NIBS based on ipsilesional corticomotor function.
Objective: To review and assess the application of repetitive transcranial magnetic stimulation (rTMS) protocols that aimed to improve upper limb motor performance after stroke.
Methods: A PubMed search was conducted for studies published between 1st January 2005 and 1st November 2022 using rTMS to improve upper limb motor performance of human adults after stroke. Studies were grouped according to whether facilitatory or suppressive rTMS was applied to the contralesional hemisphere.
Results: Of the 492 studies identified, 70 were included in this review. Only 2 studies did not conform to the interhemispheric competition model, and facilitated the contralesional hemisphere. Only 21 out of 70 (30%) studies reported motor evoked potential (MEP) status as a biomarker of ipsilesional corticomotor function. Around half of the studies (37/70, 53%) checked whether rTMS had the expected effect by measuring corticomotor excitability (CME) after application.
Conclusion: The interhemispheric competition model dominates the application of rTMS post-stroke. The majority of recent and current studies do not consider bimodal balance recovery model for the application of rTMS. Evaluating CME after the application rTMS could confirm that the intervention had the intended neurophysiological effect. Future studies could select patients and apply rTMS protocols based on ipsilesional MEP status.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10685705 | PMC |
| http://dx.doi.org/10.1177/15459683231209722 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The cutaneous sympathetic blockade associated with labour epidural analgesia: a quasi-experimental study conducted during labour and after delivery.
Br J Anaesth
September 2025
MSk Lab, Imperial College London, London, UK; Theatres and Anaesthetics, Imperial College Healthcare NHS Trust, London, UK. Electronic address:
Background: The mechanisms contributing to epidural-related maternal hyperthermia remain unclear. One explanation is that blockade of cholinergic sympathetic nerves prevents active vasodilation and sweating. However, it is not known how labour epidural analgesia affects cutaneous sympathetic function.
View Article and Find Full Text PDFSubcutaneous enucleation of the radial neck in a Monteggia-like fracture: an exceptional variant.
Int J Surg Case Rep
August 2025
CHU Joseph Ravoahangy Andrianavalona, Service de Chirurgie Orthopédique et Traumatologique, 101 Tananarive, Madagascar.
Introduction And Importance: Monteggia lesions combine a fracture of the ulna with dislocation of the radial head. Monteggia-like variants add a radial head fracture. We report a unique Monteggia-like injury with a bifocal radial fracture and subcutaneous enucleation of the radial neck, which does not fit existing classifications.
View Article and Find Full Text PDFUpper limb fragility fractures: A missed opportunity.
Ann Acad Med Singap
July 2025
Department of Orthopaedic Surgery, Woodlands Health, Singapore.
Psychometric properties of Brachial Plexus outcome measure: COSMIN-based systematic review.
Disabil Rehabil
September 2025
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Purpose: Children with incomplete recovery from Brachial Plexus Birth Injury (BPBI) experience varying degrees of upper limb impairment, and 20-30% require interventions to optimize function. A psychometrically validated measure of upper limb activity capacity is essential to guide shared clinical decisions for surgical and rehabilitation interventions.
Materials And Methods: Following the Joanna Briggs Institute Manual for Evidence Synthesis, this systematic review included studies on the measurement properties of the Brachial Plexus Outcome Measure (BPOM) - Activity Scale, a performance-based outcome measure of upper limb activity capacity in children with BPBI.
Selective Upper-Trunk and Axillary Nerve Block for Awake Shoulder Arthroscopy in a Pulmonary Compromised Patient: A Case Report.
A A Pract
September 2025
From the Department of Anesthesiology and Critical Care Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium.
A 48-year-old man with a superior labral tear and medical history including hemidiaphragmatic paresis, obstructive sleep apnea, vocal cord paresis, and glottic narrowing, underwent arthroscopic biceps tenodesis. Reduction in respiratory function presented anesthetic management challenges with general anesthesia or an interscalene brachial plexus block. Instead, ultrasound guidance was used to deliver a selective upper-trunk block with 1 % lidocaine and an axillary nerve block with 0.
View Article and Find Full Text PDF