Effects of Transcranial Magnetic Stimulation on Patients of Poststroke Upper Extremity Motor Impairment: A Randomized, Controlled Trial.

Objective: This study compared the effects of continuous theta burst stimulation (cTBS) and low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) on cortical activity modulation and upper limb motor recovery in subacute stroke patients.

Design: A total of 105 subacute stroke patients with unilateral upper limb impairment were randomly divided into three groups: cTBS, LF-rTMS, and sham. Main outcomes included Fugl-Meyer Assessment (UEFM) and modified Barthel Index (MBI) scores at baseline, 4 weeks (post-treatment), and 12 weeks (follow-up). Secondary outcomes evaluated cortical activation via functional near-infrared spectroscopy (fNIRS).

Results: Among 103 recruited participants, 98 completed follow-up. Both cTBS and LF-rTMS groups showed significantly greater UEFM improvement than the sham group at 4 and 12 weeks (P < 0.05), while MBI scores did not differ significantly. fNIRS revealed that active treatments suppressed contralesional primary motor cortex activation, with cTBS additionally inhibiting premotor and supplementary motor areas.

Conclusion: cTBS and LF-rTMS effectively enhanced upper limb motor motricity in stroke patients compared to sham stimulation, suggesting their potential as non-invasive neuromodulatory therapies for post-stroke rehabilitation.