Combined application of TMS/tDCS with intensive occupational therapy for upper limb hemiparesis

本研究的主要目的是阐明重复经颅磁刺激(RTMS)和经颅直流电刺激(TDC)对中风后上肢偏瘫的治疗效果，并探讨RTMS/TDC与强化康复训练相结合的临床效果。因此，在非皮损大脑半球连续应用低频RTMS结合强化作业治疗是安全的，而且似乎有可能改善中风后患者患侧上肢的运动功能。此外，这种结合显著降低了患侧上肢异常增加的肌张力，显示了干预的抗痉挛效果。不幸的是，由于意外的机械故障，TDCs对中风后上肢运动功能的影响到目前为止还没有充分的阐明。

The main purpose of this study was to clarify the most beneficial therapeutic approach for upper limb hemiparesis after stroke among some modalities of repetitive transcranial magnetic stimulation(RTMS) and transcranial direct current stimulation(TDCS), and to investigate the clinical effect of combined application of RTMS/TDCS and intensive rehabilitative training. As a result, consecutive application of low-frequency RTMS over the non-lesional hemisphere with intensive occupational therapy was safe and seemed to have a potential to improve motor function of the affected upper limb in post-stroke patients. In addition, this combination significantly reduced abnormally increased muscle tonus of the affected upper limb, indicating the anti-spastic effect of the intervention. Unfortunately, the effect of TDCS on upper limb motor function after stroke has not been elucidated sufficiently so far, because of unexpected mechanical trouble with the device.