Transcranial magnetic stimulation in motor recovery after stroke

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Stroke is a leading cause of long-term disability worldwide, often leaving survivors with significant motor impairments. In recent years, Transcranial Magnetic Stimulation (TMS) has emerged as a promising, non-invasive method to promote motor recovery after stroke. TMS uses magnetic fields to stimulate specific areas of the brain, potentially reactivating neural pathways and improving motor function. This technique is gaining traction as both a stand-alone therapy and as an adjunct to physical rehabilitation.

Understanding TMS and How It Works:

TMS involves placing a magnetic coil near the scalp, which sends magnetic pulses to targeted areas of the brain. These pulses can either excite or inhibit neural activity, depending on the frequency used. After a stroke, the affected hemisphere of the brain often becomes less active, while the unaffected side may become overactive. TMS aims to restore balance between the two hemispheres by either stimulating the damaged area or suppressing the overactive one.

TMS in Post-Stroke Motor Recovery:

Studies have shown that TMS can significantly enhance motor recovery in stroke patients, particularly when applied early in the recovery process. The treatment helps in re-establishing motor control by promoting neuroplasticity—the brain's ability to reorganize itself. When combined with conventional therapies like physiotherapy and occupational therapy, TMS has been found to accelerate improvements in limb strength, coordination, and mobility.

Types of TMS Used for Stroke Patients:

• Repetitive TMS (rTMS): This involves delivering multiple magnetic pulses over a specific period. High-frequency rTMS (above 5 Hz) is used to excite underactive brain regions, while low-frequency rTMS (1 Hz) is used to inhibit overactive regions.

• Theta Burst Stimulation (TBS): A newer form of TMS that delivers bursts of high-frequency stimulation over short durations. TBS is more efficient and requires shorter treatment times.

Safety and Side Effects:TMS is generally safe, with most patients experiencing only mild side effects such as headache or scalp discomfort. Serious complications like seizures are extremely rare when the procedure is administered by trained professionals. However, not all stroke patients are suitable candidates, and thorough medical evaluation is essential before beginning treatment.

Conclusion:Transcranial Magnetic Stimulation is a promising frontier in post-stroke rehabilitation. As research evolves, TMS may become a standard part of stroke recovery protocols, offering renewed hope for survivors striving to regain their independence. Early intervention and integration with conventional therapies can greatly enhance outcomes.

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