• 제목/요약/키워드: repetitive transcranial magnetic stimulation

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Effects of Motor Imagery Practice in Conjunction with Repetitive Transcranial Magnetic Stimulation on Stroke Patients

  • Ji, Sang-Goo;Cha, Hyun-Gyu;Kim, Ki-Jong;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.19 no.2
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    • pp.181-184
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    • 2014
  • The aim of the present study was to examine whether motor imagery (MI) practice in conjunction with repetitive transcranial magnetic stimulation (rTMS) applied to stroke patients could improve theirgait ability. This study was conducted with 29 subjects diagnosed with hemiparesis due to stroke.The experimental group consisted of 15 members who were performed MI practice in conjunction with repetitive transcranial magnetic stimulation, while the control group consisted of 14 members who were performed MI practice and sham therapy. Both groups received traditional physical therapy for 30 minutes a day, 5 days a week, for 6 weeks; additionally, they received mental practice for 15 minutes. The experimental group was instructed to perform rTMS and the control group was instructed to apply sham stimulation for 15 minutes. Gait analysis was performed using a three-dimensional motion capture system, which is a real-time tracking device that delivers data via infrared reflective markers using six cameras. Results showed that the velocity, step length, and cadence of both groups were significantly improved after the practice (p<0.05). Significant differences were found between the groups in velocity and cadence (p<0.05) as well as with respect to the change rate (p<0.05) after practice. The results showed that MI practice in conjunction with rTMS is more effective in improving gait ability than MI practice alone.

The Effects of Repetitive Transcranial Magnetic Stimulation on the Gait of Acute Stroke Patients

  • Ji, Sang-Goo;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.20 no.2
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    • pp.129-132
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    • 2015
  • The aim of the present study was to examine whether repetitive transcranial magnetic stimulation (rTMS) can improve gait ability of acute stage stroke patients. This study was conducted with 39 subjects who were diagnosed as having a hemiparesis due to stroke. The experimental group included 20 subjects who underwent repetitive transcranial magnetic stimulation and the control group included 19 subjects who underwent sham therapy. The stroke patients in the experimental group underwent conventional rehabilitation therapy and rTMS was applied daily to the hotspot of the lesional hemisphere. The stroke patients in the control group underwent sham rTMS and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for four weeks. Temporospatial gait characteristics, such as stance phase, swing phase, step length in affected side, velocity, and cadence, were assessed before and after the four week therapy period. A significant difference was observed in post-treatment gains for the step length in the affected side, velocity, and cadence between the experimental group and control group ( p < 0.05). However, no significant differences were observed between the two groups on stance phase and swing phase ( p > 0.05). We conclude that rTMS may be beneficial in improving the effects of acute stage stroke on gait ability.

국소 허혈성 뇌졸중 모델 흰쥐의 인지기능에 반복경두개자기자극이 미치는 효과 (Effects of Repetitive Transcranial Magnetic Stimulation on Enhancement of Cognitive Function in Focal Ischemic Stroke Rat Model)

  • 이정인;김계엽;남기원;이동우;김기도;김경윤
    • 대한물리의학회지
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    • v.7 no.1
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    • pp.11-20
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    • 2012
  • Purpose : This study is intended to examine the repetitive transcranial magnetic stimulation on cognitive function in the focal ischemic stroke rat model. Methods : This study selected 30 Sprague-Dawley rats of 8 weeks. The groups were divided into two groups and assigned 15 rats to each group. Control group: Non-treatment after injured by focal ischemic stroke; Experimental group: application of repetitive transcranial magnetic stimulation(0.1 Tesla, 25 Hz, 20 min/time, 2 times/day, 5 days/2 week) after injured by focal ischemic stroke. To assess the effect of rTMS, the passive avoidance test, spatial learning and memory ability test were analyzed at the pre, 1 day, $7^{th}$ day, $14^{th}$ day and immunohistochemistric response of BDNF were analyzed in the hippocampal dentate gyrus at $7^{th}$ day, $14^{th}$ day. Results : In passive avoidance test, the outcome of experimental group was different significantly than the control group at the $7^{th}$ day, $14^{th}$ day. In spatial learning and memory ability test, the outcome of experimental group was different significantly than the control group at the $7^{th}$ day, $14^{th}$ day. In immunohistochemistric response of BDNF in the hippocampal dentate gyrus, experimental groups was more increased than control group. Conclusion : These result suggest that improved cognitive function by repetitive transcranial magnetic stimulation after focal ischemic stroke is associated with dynamically altered expression of BDNF in hippocampal dentate gyrus and that is related with synaptic plasticity.

Repetitive Transcranial Magnetic Stimulation Combined with Task Oriented Training to Improve Upper Extremity Function After Stroke

  • Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.19 no.2
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    • pp.170-173
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    • 2014
  • The purpose of the present study was to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) in conjunction with task oriented training, on cortical excitability and upper extremity function recovery in stroke patients. This study was conducted with 31 subjects who were diagnosed as a hemiparesis by stroke. Participants in the experimental (16 members) and control groups (15 members) received rTMS and sham rTMS, respectively, during a 10 minutes session, five days per week for four weeks, followed by task oriented training during a 30 minutes session, five days per week for four weeks. Motor cortex excitability was performed by motor evoked potential and upper limb function was evaluated by motor function test. Both groups showed a significant increment in motor function test and amplitude, latency in motor evoked potential compared to pre-intervention (p < 0.05). A significant difference in post-training gains for the motor function test, amplitude in motor evoked potential was observed between the experimental group and the control group (p < 0.05). The findings of the current study demonstrated that incorporating rTMS in task oriented training may be beneficial in improving the effects of stroke on upper extremity function recovery.

Effects of Repetitive Transcranial Magnetic Stimulation on Motor Recovery in Lower Extremities of Subacute Stage Incomplete Spinal Cord Injury Patients: A Randomized Controlled Trial

  • Ji, Sang-Goo;Cha, Hyun-Gyu;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.20 no.4
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    • pp.427-431
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    • 2015
  • The aim of this study was to investigate whether repetitive transcranial magnetic stimulation (rTMS) can improve motor recovery in the lower extremities of the patients with subacute stage spinal cord injury (SCI). This study was conducted with 19 subjects diagnosed with paraplegia because of SCI. The experimental group included 10 subjects who underwent active rTMS, and the control group included 9 subjects who underwent sham rTMS. The SCI patients in the experimental group underwent conventional rehabilitation therapy, and active rTMS was applied daily to the hotspot of the lesional hemisphere. The SCI patients in the control group underwent sham rTMS and conventional rehabilitation therapy. The participants in both the groups received therapy five days per week for six weeks. Latency, amplitude, and velocity were assessed before and after the six-week therapy period. A significant difference in post-treatment gains for the latency and velocity was observed between the experimental and control groups (p < 0.05). However, no significant differences in the amplitude were observed between the two groups (p > 0.05). The results of this study indicate that rTMS may be beneficial in improving motor recovery in the lower extremities of subacute stage SCI patients.

The Effects of Repetitive Transcranial Magnetic Stimulation on Balance Ability in Acute Stroke Patients

  • Ji, Sang-Goo;Shin, Young-Jun;Kim, Myoung-Kwon
    • 대한물리의학회지
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    • v.11 no.3
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    • pp.11-17
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    • 2016
  • PURPOSE: The aim of the present study was to determine whether high frequency repetitive transcranial magnetic stimulation (rTMS) can improve balance ability in acute stage stroke patients. METHODS: The study was conducted on 30 subjects diagnosed with hemiparesis caused by stroke. The experimental group consisted of 15 patients that underwent rTMS for 15 mins and the control group consisted of 15 patients that underwent sham rTMS (for 15 minutes). A 70-mm figure 8 coil and a Magstim Rapid stimulator was used in both groups. Patients in the experimental group received 10 Hz rTMS applied to the hotspot in the lesioned hemisphere in 10-second trains with 50-second intervals between trains, for 15 minutes (total 2,000 pulses). Both groups received conventional physical therapy for 30 minutes a day, 5 days a week, for 4 weeks. Static balance ability analysis was performed using the Gaitview system to measure pressure rate, postural sway, and total pressure, and dynamic balance ability analysis was performed to measure pressure variables using a balance system. RESULTS: A significant difference was observed in post-training gains for pressure rate, total pressure in static balance, and overall stability index in dynamic balance between the experimental group and the control group (p<.05). CONCLUSION: The results of this study indicate that high frequency rTMS may be beneficial for improving static and dynamic balance recovery in acute stroke patients.

The Effects of Repetitive Transcranial Magnetic Stimulation Integrated Mirror Therapy on the Gait of Chronic Stroke Patients

  • Cha, Hyun-Gyu;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.20 no.2
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    • pp.133-137
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    • 2015
  • This study was conducted to determine the effects of repetitive transcranial magnetic stimulation (rTMS) integrated mirror therapy on the gait of post-stroke patients. Thirty patients who were six months post-stroke were assigned to either the experimental group (n = 15) or the control group (n = 15). Stroke patients in the experimental group underwent rTMS and mirror therapy for the lower limbs, while those in the control group underwent rTMS and sham therapy. Participants in both groups received therapy five days per week for four weeks. A significant difference in post-training gains for the single support phase, step length, stride length and velocity was observed between the experimental group and the control group (p < 0.05). The experimental group showed a significant increment in the single support phase, step length, stride length, swing phase, velocity, cadence, double support phase and step width as compared to pre-intervention (p < 0.05). The control group showed a significant increment in step length, velocity, cadence and step width compared to preintervention (p < 0.05). Further investigation of the availability and feasibility of rTMS integrated mirror therapy for post-stroke patients as a therapeutic approach for gait rehabilitation is warranted.

Effects of Mental Practice in Conjunction with Repetitive Transcranial Magnetic Stimulation on the Upper Limbs of Sub-acute Stroke Patients

  • Ji, Sang-Goo;Kim, Myoung-Kwon;Cha, Hyun-Gyu
    • Journal of Magnetics
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    • v.19 no.4
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    • pp.353-356
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    • 2014
  • The aim of the present study was to examine whether mental practice (MP) in conjunction with repetitive transcranial magnetic stimulation (rTMS) can improve the upper limb function of sub-acute stroke patients. This study was conducted with 32 subjects who were diagnosed with hemiparesis by stroke. The experimental group consisted of 16 members upon each of whom was performed MP in conjunction with rTMS, whreas the control group consisted of 16 members upon each of whom was performed MP and sham rTMS. Both groups received traditional physical therapy for 30 minutes a day, 5 days a week, for 6 weeks; additionally, they received mental practice for 15 minutes a day. The experimental group was instructed to perform rTMS, and the control group was instructed to apply sham rTMS for 15 minutes. A motor cortex excitability analysis was performed by motor evoked potentials (MEPs), and upper limb function was evaluated by Fugl-Meyer Assessment (FMA) and the Box and Block test (BBT). Results showed that the amplitude, latency, FMA, and BBT of the experimental group and the latency, FMA, and BBT of the control group were significantly improved after the experiment (p<0.05). Significant differences were found between the groups in amplitude and latency after the experiment (p<0.05). The results showed that MP in conjunction with rTMS is more effective in improving upper limb function than MP alone.

만성 뇌졸중 시 반복경두개자기자극에 의한 경직성 발목관절의 관절가동 범위 향상 및 H-반사 억제 효과 (The Effect of Repetitive Transcranial Magnetic Stimulation on H-Reflex Inhibition and Fascilitation of Range of Motion of Spastic Ankle Joint in Chronic Stroke Patients)

  • 조미숙
    • 대한물리의학회지
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    • v.6 no.1
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    • pp.71-79
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    • 2011
  • Purpose : The purpose of this study was carried out to investigate the effect of repetitive transcranial magnetic stimulation on increase of H-reflex inhibition and fascilitation of range of motion of spastic ankle joint in chronic stroke patients. Methods : 30 chronic stroke patients were randomly divided into three groups, a control group(placebo rTMS group), 5 Hz rTMS group and manual therapy group. The MAS and ROM of ankle joint and H-reflex inhibition of soleus muscle were evaluated on each group. Results : The rTMS group decreased MAS of ankle joint and increased H-reflex inhibition of soleus muscle, and ROM of ankle joint than manual therapy group. The placebo rTMS group did not affected the change of MAS, ROM of ankle joint and H-reflex inhibition of soleus muscle. Conclusion : The rTMS was a good therapeutic tool to improve the foot drop in the chronic stroke patients.

반복 경두개자기자극술의 우울증 치료효과 및 최신동향에 대한 고찰 (Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation for Treatment of Depression and Latest Trends in TMS Techniques)

  • 김신태;김혜원;김세주;강지인
    • 생물정신의학
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    • v.24 no.3
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    • pp.95-109
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    • 2017
  • 본 종설에서는 우울증에서의 rTMS 임상연구를 임상특성과 TMS 적용방법을 고려하여 체계적으로 고찰하였으며 새로운 TMS 치료기법에 대해 살펴보았다. rTMS는 항우울제에 반응이 적은 단극성 우울증 환자의 치료에 병용 혹은 단독요법으로 사용될 수 있는 안전하고 비침습적인 뇌조절술이다. rTMS는 고빈도 좌측 DLPFC, 저빈도 우측 DLPFC, 그리고 양측성 DLPFC 적용방법이 비슷한 수준으로 허위자극에 비해 유의하게 항우울효과를 가지고 있다. 그러나 치료저항성 단극성 우울증에 대한 항우울효과 크기는 작았다. 또한 정신병적 증상이 동반된 우울증의 치료와 양극성 장애의 우울삽화에 대해서는 치료효과가 불분명하다. 기존 rTMS의 항우울효과 크기는 작은 정도로 그 효과를 증진시키기 위해 고용량의 자극, 보다 깊이 자극할 수 있는 코일을 이용한 rTMS 치료, 표적영역에 보다 정확하게 코일을 위치시키는 신경항법 등을 이용한 TMS 적용 등의 새로운 시도들이 진행되고 있다. 또한 세타돌발자극과 자기경련치료와 같은 새로운 치료기법을 이용한 시도가 우울증 치료의 새로운 장을 열고 있다. 비록 현재까지 rTMS의 항우울효과가 만족할 만한 수준은 아니지만 임상양상을 세분화한 치료적용과 개선된 치료기법의 적용 등을 통해 더 많은 후속 연구가 이루어질 필요가 있다. 또한 여러 형태의 TMS 기법에 대해 잘 설계된 허위자극에 대한 통제연구뿐만 아니라 서로의 비교연구를 통해 우울증 치료에서의 근거수준을 높일 수 있을 것으로 기대한다.