Gómez-Fernández L, Padilla-Puentes E, Cabrera-Abreu I, Zaldívar-Bermúdez M, Morales-Chacón L, Sánchez-Coroneaux A, Días-La Fe A, Galvizu-Sánchez R, Quesada-Rodríguez E, Grass-Fernández D

Language: Spanish
References: 33
Page: 15-25
PDF size: 266.05 Kb.

ABSTRACT

Introduction: Many patients remain with some grade of chronic disability after stroke. Repetitive transcranial magnetic stimulation (rTMS) could be an adjuvant in rehabilitation for the improvement of clinical results.
Objective: To evaluate the safety and efficacy of rTMS in patients with stroke.
Methods: We designed a phase I-II clinical trial, including 15 stroke patients who were hospitalized in the international Center for Neurological Restoration from March 2010 to December 2013; they were randomized in two groups for real rTMS treatment (A,10Hz ipsilateral affected hemisphere, M1 area; B.1Hz, contralateral hemisphere) and a placebo one (C). All of them were hospitalized and received an intensive rehabilitation treatment daily during 7 hours. Additionally, they received 20 rTMS sessions according to their group assignment. They were evaluated twice (before and after treatment) by other blind researchers using the Scandinavian Scale for Stroke (SSS) and Barthel's Index.
Results: One patient from the group A with multiple undetected risk factors had a seizure during rTMS session (excluded); other two abandoned the treatment for reasons non-related to adverse events (group B). The other 12 completed all the sessions with minimal adverse events. All the groups improved the scale scores after treatment; patients who received rTMS showed the biggest differences in the final scores relative to the initial scores; specially in the hand motor function score from the SSS (A; initial: 2.5±1.9, final: 4.5±1; B, initial: 2.6±2.3, final: 4±3.4; C, initial: 3.2±2.2, final: 3.2±2.2; p‹0.05).
Conclusions: rTMS was well tolerated and it was associated with a positive therapeutic effect in both stimulation protocols that were used combined with rehabilitation.

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