Clinical Study On The Effect Of High-Frequency Repetitive Transcranial Magnetic Stimulation On Motor Function Of Hemiplegic Limbs In Stroke Patients

Objective: Stroke is one of the diseases with the highest disability rate at present,and motor dysfunction after stroke is the most important factor leading to disability,so rehabilitation of motor dysfunction is bound to become the main task and goal of rehabilitation after stroke.The application of noninvasive brain stimulation technology in mental and neurological disorders after brain injury has become a hot research topic in recent years.The purpose of this study was to investigate the efficacy of high-frequency transcranial magnetic stimulation(HF-r TMS)on improving motor function of upper and lower limbs of stroke hemiplegia.Methods: 50 patients with post-stroke hemiplegia were divided into experimental group(n = 25)and control group(n = 25)by random number table method.All patients met the inclusion and exclusion criteria.The experimental group was treated with 5Hz repetitive transcranial magnetic stimulation(TMS)in M1 area of the affected side,while the control group was treated with TMS pseudo-stimulation in M1 area of the affected side.Both groups were combined with conventional hemiplegic limb rehabilitation therapy for 2 weeks.After 5 consecutive treatments per week,rest for 2 days.Fugl-Meyer scale(upper and lower limbs)assessment,hand grip strength test and motor evoked potential(MEP)latency and amplitude assessment were performed 1 day before the first treatment and 15 days after the treatment.Gait analyzer was used to evaluate 17 patients in the experimental group and 15 patients in the control group.Stride speed,stride frequency,stride length,stride width,walking cycle,double support time,affected side support time,affected side swing time,healthy side support time,healthy side swing time and other related parameters were recorded.Results: 1.There were no statistically significant differences between the general data such as sex and age of the patients in the pre-treatment magnetic stimulation experimental group and the pseudo-stimulation control group,as well as the holding strength,upper and lower limb Fugl-Meyer score,MEP incubation period and amplitude,and gait analyzer evaluation data(p>0.05);2.After 2 weeks of treatment,compared with the control group,the grip strength,upper limb Fugl-Meyer score and MEP amplitude of the highfrequency stimulation group were significantly improved(p<0.05),however,there were no obvious statistical differences in MEP cortical latency,lower limb Fugl-Meyer score and gait analysis,including: stride speed,cadence,stride length,stride width,walking cycle,double support time,affected side support time,patient swing time,healthy side support time,and healthy side swing time(p>0.05);3.Before and after treatment,there was a statistical difference in all observation indexes between the two groups and before treatment(p<0.05).Conclusion: 1.High-frequency repetitive transcranial magnetic stimulation combined with conventional rehabilitation therapy in the M1 area of the affected side is more beneficial to the recovery of upper limb motor function in stroke patients with hemiplegia than conventional rehabilitation therapy alone;2.There was no significant difference in the improvement of lower limb function after stroke between high-frequency repetitive transcranial magnetic stimulation combined with conventional rehabilitation therapy in M1 area of the affected side and conventional rehabilitation therapy alone;3.Highfrequency repetitive transcranial magnetic stimulation in the M1 area of the affected side combined with conventional rehabilitation treatment can improve the MEP amplitude electrophysiological parameters.