Stroke can lead to loss of motor function in individuals, severely limiting independence in activities of daily living. Transcranial magnetic stimulation (TMS) is a neuromodulation method that aims to reduce these losses by affecting the motor areas of the brain. Continuous theta burst stimulation (cTBS), an innovative mode of TMS, aims to provide effective results with shorter treatment sessions. Published in 2023 in the journal Stroke, the study titled "Continuous Theta-Burst Stimulation of the Contralesional Primary Motor Cortex for Promotion of Upper Limb Recovery After Stroke: A Randomised Controlled Trial" conducted by Jord J.T. Vink and colleagues evaluated the effects of cTBS on recovery after stroke in detail.
This study was conducted between 2017 and 2021 and was conducted on 60 patients who had a stroke. Patients were divided into two groups, those receiving active cTBS treatment and those receiving placebo treatment. The treatment was initiated within the first three weeks after stroke onset and was administered in short daily sessions for 10 days. During treatment, cTBS was targeted to the contralateral motor cortex of the brain and this was supported by standardised upper limb rehabilitation. During treatment, cTBS was targeted to the contralateral motor cortex followed by standardised upper extremity rehabilitation. The aim of cTBS is to support the motor function of the affected limb by restoring the balance of motor stimulation between the two hemispheres of the brain.
The results showed that cTBS led to a significant improvement in motor functioning in the first 3 months and this effect was largely maintained throughout the first year. According to measures such as Action Research Arm Test (ARAT) and Fugl-Meyer Assessment (FMA), patients in the active cTBS group showed remarkable improvements in fine motor skills and manual dexterity. Furthermore, these patients were discharged from the rehabilitation centre 18 days earlier and had a significant improvement in quality of life. The safety profile of the treatment was also favourable. The most commonly reported mild side effect was headache and no serious complications were reported. This confirms that cTBS is a safe and tolerable method.
In conclusion, cTBS stands out as an effective treatment method in stroke rehabilitation that both accelerates short-term recovery and provides lasting benefits in the long term. Supporting these findings with larger-scale studies may lead to the use of the method in widespread clinical practice. In post-stroke recovery processes, cTBS is considered as an important tool that can increase the independence and quality of life of individuals.
Bibliography:
1-Jord J.T. Vink et al., https://doi.org/10.1161/STROKEAHA.123.042924
