Full
Outline
To explore the clinical efficacy and brain mechanism of repetitive transcranial magnetic stimulation (rTMS) based on structural preservation in treating upper limb motor dysfunction after stroke.
Motor evoked potential (MEP) elicitation was used as the evaluation index of structural preservation. A total of 60 stroke patients with upper limb motor dysfunction and absent MEP were enrolled. They were randomly divided into the contralateral high-frequency group, contralateral low-frequency group, ipsilateral high-frequency group, and sham stimulation group using the random number table and double-blind method. Before and after the experiment, the upper limb Fugl-Meyer assessment (UL-FMA), functional independence measure (FIM), and functional near-infrared spectroscopy (fNIRS) were performed.
There were no statistically significant differences in general data, pre-treatment UL-FMA scores, FIM scores, or mean oxyhemoglobin (HbO) concentration in the region of interest among the groups (P>0.05). After treatment, the UL-FMA scores of each group were significantly different from those before treatment (P<0.05), and the contralateral high-frequency group showed a statistically significant difference compared with the sham stimulation group (P<0.05). The FIM scores of each group were significantly different from those before treatment (P<0.05), but there was no statistically significant difference among the four groups (P>0.05). Compared with the sham stimulation group, the changes in HbO activation before and after treatment in the contralateral high-frequency group were mainly located in the ipsilateral premotor cortex (PMC), supplementary motor area (SMA), and frontal eye field (FEF), with statistically significant differences (P<0.05).
In severe stroke patients with absent MEP, contralateral high-frequency repetitive transcranial magnetic stimulation (rTMS) yields greater improvements in upper limb motor function (UL-FMA) and induces stronger activation of specific ipsilateral brain regions (PMC, SMA, FEF) compared to sham stimulation. Nevertheless, its efficacy relative to contralateral low-frequency and ipsilateral high-frequency rTMS warrants further validation through larger-scale studies.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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