High-frequency contralesional dorsal premotor cortex and low-frequency contralesional primary motor cortex rTMS in subacute stroke with severe upper limb impairment: comparable motor outcomes and differential regional degree centrality changes.

In 30 seconds

This randomized controlled trial evaluated the effects of high-frequency rTMS over the contralesional dorsal premotor cortex versus low-frequency rTMS over the contralesional primary motor cortex in 46 patients with severe upper limb impairment following subacute ischemic stroke. Both interventions led to significant improvements in motor function, with no significant differences between groups (p > 0.05).

Key findings

• Both rTMS groups showed significant improvements in the Fugl-Meyer Assessment for Upper Extremity (p < 0.01).
• No significant between-group differences in behavioral outcomes were observed (p > 0.05).
• High-frequency rTMS resulted in greater degree centrality changes in specific brain regions compared to low-frequency rTMS (p < 0.05).
• Degree centrality changes in the ipsilesional middle occipital gyrus correlated with improvements in motor function (r = 0.619, p = 0.018).

Why it matters

Understanding the efficacy of different rTMS protocols can inform rehabilitation strategies for patients with severe upper limb impairment post-stroke, potentially enhancing recovery outcomes.