Effects Of Repetitive Transcranial Magnetic Stimulation On Rehabilitation Of Upper Limb Motor Function In Patients With Acute Cerebral Infarction

Objective:To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)at different frequency on the rehabilitation of upper limb motor function in patients with acute cerebral infarction.Experimental methods:A total of 105 patients with acute cerebral infarction hospitalized in our Department of Neurology and Rehabilitation from September 2017 to July 2018 were recruited.They were divided at random into 3 groups: high-frequency stimulation group(36 cases),low-frequency stimulation group(35 cases)and pseudo-stimulation group(34 cases).When patients had stable vital signs,the Erude CYY-I-type magnetic stimulator would give 8-shaped focusing stimulus coil stimulation.All three groups received regular drug and rehabilitation therapy for 10 consecutive dayswhile undergoing repeated transcranial magnetic stimulation and the following assessments were performed prior to and after treatment: Upper Extremity Fugl-Meyer(FMA)motor function Score,Wolf Motor Function Test(WMFT),Action Research Arm Test(ARAT)score,Postural Assessment Scale for Stroke Patients PASS,Modified Barthel Index(MBI),Neurological deficit score(NIHSS)and Motor evoked potential(MEP)and centralmotor conduction time(CMCT)Physiological test.Results:1.FMA score,MBI score and PASS score of patients in high frequency group,low frequency group and pseudo stimulus group after 10 days were significantly increased compared to those before treatment(P <0.01).Compared with pseudo-stimulation group,the scores of high and low-frequency group had significant difference(P<0.01),but there was no significant difference between high-frequency group and low-frequency group(P> 0.05).2.The WMFT score and ARAT score of patients in high frequency group,low frequency group and pseudo stimulus group after 10 days of treatment were significantly increased compared to those before treatment(P<0.01).Compared with pseudo-stimulation group,the scores of high and low-frequency group had significant difference(P <0.01),but there was no significant difference between high-frequency group and low-frequency group(P> 0.05).3.The NIHSS scores of three groups after 10 days of treatment were significantly decreased compared with those before treatment(P<0.01).Compared with pseudostimulation group,the scores of high and low-frequency group had significant difference(P <0.01),but there was no significant difference between high-frequency group and low-frequency group(P> 0.05).4.The cortical latency of MEP and CMCT scores in the three groups after 10 days of treatment were significantly decreased compared to those before treatment(P<0.01).Compared with pseudo-stimulation group,high and low-frequency group had significant difference(P <0.01),but there was no significant difference between highfrequency group and low-frequency group(P> 0.05).5.The incidence of adverse events in the three groups were relatively low,and there was no significant difference among the three groups.Conclusion:Our present study shows that repetitive transcranial magnetic stimulation at high frequency(10Hz)and low frequency(1Hz)can significantly improve the upper limb motor function of patients with acute cerebral infarction,however there is no significant difference between the two groups in limb rehabilitation.