Repetitive transcranial magnetic stimulation on the modulation of cortical and spinal cord excitability in individuals with spinal cord injury

Advancing post-stroke cognitive rehabilitation through high-frequency neurostimulation: A retrospective evaluation of cortical excitability and biomarker modulation

BackgroundPost-stroke cognitive impairment (PSCI) poses significant challenges to patient independence, yet technological interventions like high-frequency repetitive transcranial magnetic stimulation (rTMS) remain underexplored in clinical neurorehabilitation.ObjectiveThis study evaluates the integration of high-frequency rTMS into standard care, focusing on its technological efficacy in modulating neuroplasticity and serum biomarkers to enhance cognitive and functional recovery.MethodsA retrospective analysis of 80 PSCI patients (2021-2023) compared outcomes between a conventional care group (n = 30) and an rTMS group (n = 50) receiving 20 Hz stimulation (YRD-CCY-I device) targeting the dorsolateral prefrontal cortex. Key metrics included Montreal Cognitive Assessment (MoCA), Barthel Index (BI), cortical silent period (CL), central motor conduction time (CMCT), and serum neurotrophic factors (BDNF, VEGF, IGF-1).ResultsPost-intervention, the rTMS group demonstrated superior MoCA scores (19.25 vs. 15.24, p = 0.001), BI (76.36 vs. 70.13, p = 0.001), and IADL (20.38 vs. 18.13, p = 0.001) compared to controls. Neurophysiological markers revealed prolonged CL (25.30 vs. 24.02 ms, p = 0.001) and shortened CMCT (12.05 vs. 12.98 ms, p = 0.001), alongside elevated BDNF (9.56 vs. 7.34 ng/mL), VEGF (156.48 vs. 110.54 pg/mL), and IGF-1 (153.74 vs. 112.90 ng/mL, p = 0.001). Overall efficacy was 94% for rTMS versus 73.33% for conventional care (p = 0.047).ConclusionHigh-frequency rTMS, as a targeted neurostimulation technology, enhances cognitive recovery and cortical adaptability in PSCI by modulating neuroplasticity and upregulating neurotrophic biomarkers. These findings underscore its potential as a scalable adjunct in technology-driven neurorehabilitation programs.

The effectiveness and safety of repetitive transcranial magnetic stimulation on spasticity after upper motor neuron injury: A systematic review and meta-analysis

To systematically evaluate the effectiveness and safety of repetitive transcranial magnetic stimulation (rTMS) on spasticity after upper motor neuron (UMN) injury. Eight electronic databases were searched from inception to August 6, 2022. Randomized controlled trials (RCTs) investigating the effectiveness and safety of rTMS on spasticity after UMN injury were retrieved. Two reviewers independently screened studies, extracted data, and assessed the risk of bias. Review Manager 5.3 and Stata 14.0 software were used to synthesize data. The certainty of the evidence was appraised with the Grade of Recommendation, Assessment, Development and Evaluation tool. Forty-two studies with a total of 2,108 patients were included. The results of meta-analysis revealed that, compared with control group, rTMS could significantly decrease scores of the Modified Ashworth Scale (MAS) in patients with UMN injury. The subgroup analysis discovered that rTMS effectively decreased the MAS scores in patients with stroke. Meanwhile, rTMS treatment > 10 sessions has better effect and rTMS could decrease the MAS scores of upper limb. Thirty-three patients complained of twitching facial muscles, headache and dizziness, etc. In summary, rTMS could be recommended as an effective and safe therapy to relieve spasticity in patients with UMN injury. However, due to high heterogeneity and limited RCTs, this conclusion should be treated with caution.