Affiliations: Department of Neurology, Assiut University Hospital,
Assiut, Egypt
Note: [] Corresponding author: Eman M Khedr (MD), Prof. of Neurology,
Department of Neurology, Assiut University Hospital, Assiut, Egypt. Tel.: +20
088 2333355; Fax: +20 088 2333327; E-mail: emankhedr99@yahoo.com
Abstract: This review discusses the clinical results that were obtained by
applying rTMS in acute and chronic ischemic stroke patients. These studies
included only the recovery of motor disability and dysphagia. In summary, two
approaches have been used when employing rTMS as a potential therapy for the
treatment of stroke. The most direct approach involves applying rTMS directly
over the affected hemisphere in an attempt to increase excitability and
plasticity of damaged circuits to improve motor function. The second approach
has taken advantage of the concept of interhemispheric balance in which damage
to the stroke hemisphere is exacerbated by increased inhibition from the intact
non-stroke hemisphere. In this case, inhibitory rTMS is applied to the
non-stroke hemisphere with the intention of reducing interhemispheric
inhibition and restoring the balance of excitation between the motor
cortices.The overall procedure remains to be optimized, in particular regarding
the number of rTMS sessions, frequency and intensity of stimulation and the
exact timing of rTMS application after stroke. Cortical stimulation is an
effective method for improving functional recovery of acute and chronic stroke.
Keywords: Repetitive transcranial magnetic stimulation, stroke, neuroplasticity, cortical excitability
