Today, stroke is a leading cause of long-term disability worldwide. Up to half of stroke survivors struggle with continuing disability, and nearly 30% require help getting through daily activities at the sixth-month mark after their stroke.
For that reason, it is imperative that effective rehabilitation strategies be used to maximize recovery outcomes. Today, TMS has great potential as a non-invasive brain stimulation technique for enhancing stroke recovery and improving functional outcomes.
Efficacy Of TMS Therapy For Stroke Recovery
Over the last decade, research into the use of TMS for stroke recovery has increased dramatically. Several potentially useful functions of TMS stroke treatment have emerged.
Mechanisms Of TMS In Stroke Recovery
TMS is a painless, non-invasive technique that can target several areas of the brain with simple magnetic pulses at different frequencies. These pulses are administered during short, 20-minute sessions. They can be applied throughout the primary motor cortex to elicit changes brought about by a stroke.
Balance In The Brain
Under regular conditions, the brain's hemispheres are balanced, and this balance is regulated by interhemispheric inhibition. After a stroke, this balance is negatively affected, and one hemisphere can experience extreme excitability while another experiences impaired functionality. In these cases, TMS can modulate excitability throughout different areas of the brain, bringing balance back between the two hemispheres.
Improved Control
Motor skills are often impaired after a stroke because they rely on several colonies of neurons responsible for the performance of individual actions. However, the damage to some of these neurons during a stroke means the brain has to create alternative clusters of neurons for the same movements, and this can take time. It can be inhibited by the amount of damage in both hemispheres.
TMS offers an opportunity to target these areas and stimulate blood flow and neural connections where they have previously been damaged, which helps improve motor control.
Efficacy Of TMS For Stroke Recovery
But how effective is TMS for stroke recovery?
TMS Stroke And Depression Recovery
Nearly 50% of stroke survivors struggle with depression, and this leads to a reduced quality of life and adverse outcomes following their stroke. Conventional therapies for post-stroke depression do not work well on all patients. Given that TMS has been established as an FDA-approved, highly effective treatment for major depressive disorder, new research explored the efficacy of TMS for stroke and depression symptoms.
Results indicated that the use of TMS for stroke-related depression caused significant improvements with noticeably decreased depression symptoms. This improvement lasted three months with no adverse effects and high patient tolerability.
TMS And Movement-Dependent Stroke Recovery
New evidence has been researched on whether TMS is effective in helping with movement-dependent stroke recovery. For many people, post-stroke motor recovery is significantly impaired, especially in the upper extremities, but necessitates motor skill learning, which involves the primary motor cortex. Theoretically, TMS could offer a way to improve movement in the upper extremities by focusing on the neuroplasticity within the sensorimotor cortex, the area of the primary motor cortex that is often damaged.
Results have found an overall change indicating that targeted TMS in stroke recovery can improve rehabilitation interventions.
TMS And Stroke Motor Recovery
Several studies have performed a comparative analysis of TMS stroke treatment as it relates to motor recovery. Motor potentials evoked by TMS have been shown to offer clinical improvements in several mechanisms among stroke patients.
TMS Stroke Recovery And Motor Cortex Function
After a stroke, many patients have imbalances between hemispheres, but improvements in the motor cortex can be the most beneficial way to improve several symptoms after a stroke. The reason for this is that the neurophysiological effects of a stroke are generally localized in the motor cortex, and studies have found that TMS can change things like:
- Interhemispheric interaction
- Intracortical function
- Cortical motor excitability
All three of these can improve motor cortex function and rectify imbalances with interhemispheric inhibition following a stroke.
Read more about TMS For Stroke Recovery at Lifequality TMS Blog