Effect of high frequency and low frequency repetitive transcranial magnetic stimulation in the treatment of post-stroke spasticity: A comparative study

doi:10.3969/j.issn.1004-583X.2022.05.007

Abstract

Abstract:

Objective To compare the clinical effect between high frequency and low frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke spasticity. Methods Totally 54 post-stroke spasticity patients were randomely divided into the high frequency group (n=18), the low frequency group (n=18) and the control group (n=18). In addition of 4-week routine treatment (secondary prevention medications+rehabilitation training), the high frequency group were additionally treated with high-frequency rTMS on the affected side, the low frequency group additionally with low-frequency rTMS on the healthy side. The control group did not receive rTMS. The effect assessment was conducted before and after treatment. The therapeutic effect was determined by comparing the motor evoked potentials (MEP) latency of wrist flexor muscles on the affected side, central motor conduction time (CMCT), Fugl-Meyer assessment (FMA) of upper extremity (FMA-UE), Modified Ashworth Scale (MAS), clinical spasticity index (CSI), Modified Barthel Index (MBI).Results The difference was not statistically significant in the related indicators among the three groups before treatment (P>0.05). After treatment, FMA-UE, MBI score in groups were significantly increased, while wrist flexor MAS, CSI, MEP latency, CMCT were apparently decreased (P<0.05). Among the three groups, FMA, MBI were remarkably increased in the frequency groups than in the cortrol group, and wrist flexor MAS, CSI, MEP latency, CMCT were obviously decreased when compared with the cortrol group (P<0.05), the high frequency group was more prevalent (P<0.05). Conclusion For post-stroke spasticity patients, both the high frequency rTMS on the affected side and the low-frequency rTMS on the healthy side can relieve post-stroke spasticity and elevate the FMA-UE score, which is safe and effective. And the high frequency rTMS on the affected side is better than low frequency rTMS on the healthy side.

Key words: repetitive transcranial magnetic stimulation, stroke, spasticity, frequency

CLC Number:

R741.04

Xia Jing, Chen Miaocun, Lin Min, Hao Youguo. Effect of high frequency and low frequency repetitive transcranial magnetic stimulation in the treatment of post-stroke spasticity: A comparative study[J]. Clinical Focus, 2022, 37(5): 427-430.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.05.007

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I5/427

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References 18

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组别	例数	年龄 (岁)	性别 (男/女)	身高 (cm)	病程 (d)
高频组	18	69.1±1.9	10/8	170.2±1.6	76.5±35.7
低频组	18	70.4±2.1	11/7	169.3±1.7	78.2±37.5
对照组	18	69.6±1.7	10/8	169.2±1.6	74.1±33.9
χ²/F值		2.13	0.16	2.05	0.06
P值		0.13	0.93	0.14	0.95

组别	例数	年龄 (岁)	性别 (男/女)	身高 (cm)	病程 (d)
高频组	18	69.1±1.9	10/8	170.2±1.6	76.5±35.7
低频组	18	70.4±2.1	11/7	169.3±1.7	78.2±37.5
对照组	18	69.6±1.7	10/8	169.2±1.6	74.1±33.9
χ²/F值		2.13	0.16	2.05	0.06
P值		0.13	0.93	0.14	0.95

组别	例数	上肢FMA		屈腕MAS		CSI指数		MBI评分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
高频组	18	30.24±3.01	37.98±3.79^*#△	2.24±0.16	1.70±0.11^*#△	12.55±0.54	10.46±0.41^*#△	36.99±3.71	46.53±4.18^#△
低频组	18	29.73±3.03	36.12±3.38^#△	2.17±0.13	1.84±0.13^#△	12.44±0.49	10.89±0.48^#△	36.77±3.57	43.52±3.96^#△
对照组	18	30.67±3.31	33.41±3.24^△	2.23±0.15	2.01±0.14^△	12.52±0.59	11.67±0.51^△	37.28±3.91	41.69±4.01^△
F值		0.41	8.96	1.19	26.78	0.20	30.85	0.09	7.33
P值		0.67	0.0005	0.32	<0.01	0.82	<0.01	0.92	0.0016

组别	例数	上肢FMA		屈腕MAS		CSI指数		MBI评分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
高频组	18	30.24±3.01	37.98±3.79^*#△	2.24±0.16	1.70±0.11^*#△	12.55±0.54	10.46±0.41^*#△	36.99±3.71	46.53±4.18^#△
低频组	18	29.73±3.03	36.12±3.38^#△	2.17±0.13	1.84±0.13^#△	12.44±0.49	10.89±0.48^#△	36.77±3.57	43.52±3.96^#△
对照组	18	30.67±3.31	33.41±3.24^△	2.23±0.15	2.01±0.14^△	12.52±0.59	11.67±0.51^△	37.28±3.91	41.69±4.01^△
F值		0.41	8.96	1.19	26.78	0.20	30.85	0.09	7.33
P值		0.67	0.0005	0.32	<0.01	0.82	<0.01	0.92	0.0016

组别	例数	MEP潜伏期		CMCT
组别	例数	治疗前	治疗后	治疗前	治疗后
高频组	18	34.94±2.72	29.65±2.61^*#△	16.58±1.98	12.57±1.66^*#△
低频组	18	35.23±2.87	31.60±3.05^#△	16.35±1.92	13.64±1.71^#△
对照组	18	35.54±2.85	33.62±2.81^△	16.80±1.95	15.53±1.79^△
F值		0.21	8.87	0.24	14.49
P值		0.81	0.0005	0.79	<0.01