Regional Cerebral Blood Flow (rCBF) after Low-frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Combined with Intensive Occupational Therapy for Upper Limb Hemiplegia after Stroke : A Study using Single Photon Emission Computed Tomography

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  • HARA Takatoshi
    Department of Rehabilitation Medicine, The Jikei University School of Medicine
  • KAKUDA Wataru
    Department of Rehabilitation Medicine, The Jikei University School of Medicine
  • KOBAYASHI Kazushige
    Department of Rehabilitation Medicine, The Jikei University School of Medicine
  • MOMOZAKI Ryo
    Department of Rehabilitation Medicine, The Jikei University School of Medicine
  • NIIMI Masachika
    Department of Rehabilitation Medicine, The Jikei University School of Medicine
  • ABO Masahiro
    Department of Rehabilitation Medicine, The Jikei University School of Medicine

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Other Title
  • 脳卒中後上肢麻痺に対する低頻度反復性経頭蓋磁気刺激と集中的作業療法の併用療法が脳血流に及ぼす影響について
  • ノウソッチュウ ゴ ジョウシ マヒ ニ タイスル テイヒンド ハンプクセイケイ ズガイ ジキ シゲキ ト シュウチュウテキ サギョウ リョウホウ ノ ヘイヨウ リョウホウ ガ ノウ ケツリュウ ニ オヨボス エイキョウ ニ ツイテ

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Abstract

We performed a 15 day protocol of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive occupational therapy in hemiplegic upper limbs in poststroke and investigated the effect of cerebral blood flow using single photon emission computed tomography (SPECT). Seventeen chronic stroke patients were studied with SPECT at rest before and 4 weeks after undergoing the 15 day protocol. Before and after the treatment, Fugl-Meyer Assessment (FMA) score and Wolf Motor Function Test (WMFT) -Log performance time showed a significant improvement. The specific areas with a significant increase in perfusion in the affected hemisphere were the insula (BA 13), the precentral gyrus (BA 44) and the cerebellum. In the nonaffected hemisphere, perfusion was significantly increased in the lingual gyrus and cerebellum. On the other hand, perfusion was significantly decreased in the middle frontal gyrus (BA 6), precentral gyrus (BA 4) and postcentral gyrus (BA 3) in the nonaffected hemisphere. It was suggested that low-frequency rTMS combined with intensive occupational therapy effects the cerebral blood flow and contributes to improving upper limb hemiplegia after stroke.

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