Abstract Details

Title Effects of Deep Repetitive Transcranial Magnetic Stimulation (rTMS) on Motor Function of Paretic Lower Limb in Chronic Subcortical Stroke: A Study with H-Coil

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S52 - (-)

Poster/Presentation
Number 004

Objective

Background Repetitive transcranial magnetic stimulation (rTMS) has been recognized as a promising intervention for treatment of stroke patients. One main limitation in targeting the lower limb motor area is the relative depth of its cortical representation with respect to the head surface. H-coils allow to reach deeper and wider regions with respect to traditional coils.

Design/Methods Eleven patients with lower limb motor involvement after chronic stroke (> 6 months) underwent two 3-week cycles (11 sessions each) of real or sham rTMS, separated by a four-week wash-out period in random sequence. Six minutes walking test (6MWT), Fugl-Meyer lower limb (FM-LL) and 10-meter walk test (10MWT) were collected before and 1 day after the end of each cycle and at the 4 week follow-up.

Results Only the real 20 Hz rTMS was associated with significant improvement in 6MWT (p=0.03) and FMLL (p=0.005) vs baseline. This effect persisted at the 4 week follow-up, being significantly greater than after sham stimulation (6MWT p=0.04 ; FMLL p=0.01). No significant changes in 10MWT were found.

Conclusions We could demonstrate positive effects of high frequency rTMS with H-coil on walking ability and independence measures of lower limb motor function in patients with chronic stroke. These effects lasted at least one month and resulted in improved disability and walking endurance. Further studies are needed to explore in more detail the size and duration of such effects, for potential application in the treatment of walking abilities after stroke.

Authors/Disclosures
Raffaella Chieffo, MD PRESENTER	No disclosure on file
Kailash P. Bhatia, MD, FAAN (UCL)	Dr. Bhatia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ipsen. Dr. Bhatia has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MDS . Dr. Bhatia has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Arturo Nuara	No disclosure on file
	No disclosure on file
Dacia Dalla Libera, MD (San Raffaele Hospital)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Mauro Comola	No disclosure on file
	No disclosure on file
Giancarlo Comi, MD (University Vita-Salute)	Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aspen Healthcare. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Rewind.
Letizia M. Leocani, MD (University Vita-Salute San Raffaele, INSPE)	Dr. Leocani has received personal compensation in the range of $0-$499 for serving as a Consultant for Roche . Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Med-ex learning.

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