Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective.
Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective.
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DOI：
10.3389/fresc.2022.795335
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Thiel, Alexander
中科院分区：
文献类型：
--
作者：
Hildesheim, Franziska E.;Silver, Alexander N.;Dominguez-Vargas, Adan-Ulises;Andrushko, Justin W.;Edwards, Jodi D.;Dancause, Numa;Thiel, Alexander
康复对于减少卒中相关残疾和改善卒中后生活质量至关重要。重复经颅磁刺激（rTMS）是一种非侵入性神经调节技术，用作物理治疗的独立或辅助治疗，可能有利于中风患者亚组的运动恢复。加拿大无创脑刺激试验平台（CanStim）旨在通过使用标准化研究方案的临床试验和临床前研究，促进这些技术的使用，以改善中风后的恢复。在这里，我们回顾了现有的临床试验人口统计学，临床和神经生物学因素，可以预测治疗反应，以确定知识的差距，需要解决之前，实施这些参数的患者分层的临床试验方案。对卒中恢复的临床rTMS试验进行综述，确定与运动障碍卒中患者rTMS反应相关的因素，并为临床前和临床研究开发研究前景。在PubMed中进行了文献检索，使用布尔检索词stroke AND repetitive transcranial magnetic stimulation或rTMS AND motor，用于研究在任何恢复阶段使用rTMS进行卒中患者运动恢复的研究。共有1,676篇文章由两名设盲的评分员筛选，其中26篇文章被确定纳入本综述。确定了与rTMS反应相关的多种可能因素，包括卒中部位、皮质厚度、脑源性神经营养因子（BDNF）基因型、初始卒中严重程度以及与同侧半球相对保留的功能运动网络相关的几个成像和临床因素。年龄、性别和卒中后时间通常与rTMS反应无关。在兴奋性同病灶和抑制性对病灶rTMS的研究中，确定了与更大反应相关的因素。异质性的研究设计和相互矛盾的数据表明需要更大的方案标准化和高质量的对照试验。临床、脑结构和神经生物学因素已被确定为脑卒中伴运动障碍患者rTMS反应的潜在预测因素。这些因素可以为未来临床试验的设计提供信息，然后再考虑优化中风患者的个体康复治疗。专门在临床背景下开发的中风恢复临床前模型可能会加速这一过程。
Rehabilitation is critical for reducing stroke-related disability and improving quality-of-life post-stroke. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique used as stand-alone or adjunct treatment to physiotherapy, may be of benefit for motor recovery in subgroups of stroke patients. The Canadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim) seeks to advance the use of these techniques to improve post-stroke recovery through clinical trials and pre-clinical studies using standardized research protocols. Here, we review existing clinical trials for demographic, clinical, and neurobiological factors which may predict treatment response to identify knowledge gaps which need to be addressed before implementing these parameters for patient stratification in clinical trial protocols. To provide a review of clinical rTMS trials of stroke recovery identifying factors associated with rTMS response in stroke patients with motor deficits and develop research perspectives for pre-clinical and clinical studies. A literature search was performed in PubMed, using the Boolean search terms stroke AND repetitive transcranial magnetic stimulation OR rTMS AND motor for studies investigating the use of rTMS for motor recovery in stroke patients at any recovery phase. A total of 1,676 articles were screened by two blinded raters, with 26 papers identified for inclusion in this review. Multiple possible factors associated with rTMS response were identified, including stroke location, cortical thickness, brain-derived neurotrophic factor (BDNF) genotype, initial stroke severity, and several imaging and clinical factors associated with a relatively preserved functional motor network of the ipsilesional hemisphere. Age, sex, and time post-stroke were generally not related to rTMS response. Factors associated with greater response were identified in studies of both excitatory ipsilesional and inhibitory contralesional rTMS. Heterogeneous study designs and contradictory data exemplify the need for greater protocol standardization and high-quality controlled trials. Clinical, brain structural and neurobiological factors have been identified as potential predictors for rTMS response in stroke patients with motor impairment. These factors can inform the design of future clinical trials, before being considered for optimization of individual rehabilitation therapy for stroke patients. Pre-clinical models for stroke recovery, specifically developed in a clinical context, may accelerate this process.
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影响因子：
8.3
作者：
Cicinelli, P;Pasqualetti, P;Rossini, PM
通讯作者：
Rossini, PM
影响因子：
11.2
作者：
Ameli, Mitra;Grefkes, Christian;Nowak, Dennis A.
通讯作者：
Nowak, Dennis A.
影响因子：
5.5
作者：
Cheeran, Binith;Talelli, Penelope;Rothwell, John C.
通讯作者：
Rothwell, John C.
影响因子：
2.8
作者：
Bertolucci, Federica;Chisari, Carmelo;Fregni, Felipe
通讯作者：
Fregni, Felipe
DOI：
10.1523/jneurosci.1435-10.2010
发表时间：
2010-08-11
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
--
作者：
Carmel JB;Berrol LJ;Brus-Ramer M;Martin JH
通讯作者：
Martin JH