Effect of Cerebral and Cerebellar rTMS in Stroke Patient

Study Overview
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Brief Summary
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This study is based on the characteristics of motor learning theory and motor learning neural network to improve motor function in stroke patients. This study is to investigate whether the cerebral-cerebellar repetitive transcranial magnetic stimulation (rTMS) is effective in improving motor function compared to the conventional cerebral rTMS in stroke patients.

Official Title
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Effect of Cerebral and Cerebellar Repetitive Transcranial Magnetic Stimulation on Motor Function in Stroke Patients

Conditions
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Stroke, Repetitive Transcranial Magnetic Stimulation, rTMS, Motor Recovery

Intervention / Treatment
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* Procedure: Repetitive transcranial magnetic stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hemiplegic stroke patients within 1 month after onset Moderate to severe motor impairment (Fugl-Meyer assessment <85) Cognitive and language functions to perform more than one step of command More than 19 years old Exclusion Criteria: Contraindicated to rTMS Progressive or unstable stroke Pre-existing and active major neurological disease or major psychiatric disease A history of advanced liver, kidney, cardiac or pulmonary disease, a terminal medical diagnosis consistent with survival <1 year

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Facilitatory cerebral and cerebellar rTMS group<br>Patients underwent 10 consecutive daily sessions of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the affected primary motor cortex of the hand and high-frequency rTMS over the ipsilateral cerebellar hemisphere. | Procedure: Repetitive transcranial magnetic stimulation<br>* rTMS over cerebral motor cortex and cerebellar hemisphere<br>|
| Active Comparator: Facilitatory cerebral rTMS group<br>Patients underwent 10 consecutive daily sessions of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the affected primary motor cortex of the hand and sham high-frequency rTMS over the ipsilateral cerebellar hemisphere. | Procedure: Repetitive transcranial magnetic stimulation<br>* rTMS over cerebral motor cortex and cerebellar hemisphere<br>|
| Experimental: Inhibitory cerebral and cerebellar rTMS group<br>Patients underwent 10 consecutive daily sessions of continous theta bust stimulation (cTBS) over the unaffected primary motor cortex of the hand and high-frequency rTMS over the ipsilateral cerebellar hemisphere. | Procedure: Repetitive transcranial magnetic stimulation<br>* rTMS over cerebral motor cortex and cerebellar hemisphere<br>|
| Active Comparator: Inhibitory cerebral rTMS group<br>Patients underwent 10 consecutive daily sessions of continous theta bust stimulation (cTBS) over the unaffected primary motor cortex of the hand and sham rTMS over the ipsilateral cerebellar hemisphere. | Procedure: Repetitive transcranial magnetic stimulation<br>* rTMS over cerebral motor cortex and cerebellar hemisphere<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference of upper limb motor score in Fugl-Meyer assessment | (upper limb motor score in Fugl-Meyer assessment at post-intervention) - (upper limb motor score in Fugl-Meyer assessment at baseline) Higher scores mean a better outcome | 2 weeks |