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Randomized Controlled Trial
. 2013 May;94(5):803-7.
doi: 10.1016/j.apmr.2012.12.016. Epub 2013 Jan 5.

Effect of high- and low-frequency repetitive transcranial magnetic stimulation on visuospatial neglect in patients with acute stroke: a double-blind, sham-controlled trial

Bo Ryun Kim  1 , Min Ho Chun, Dae-Yul Kim, Sook Joung Lee
Affiliations
Randomized Controlled Trial

Effect of high- and low-frequency repetitive transcranial magnetic stimulation on visuospatial neglect in patients with acute stroke: a double-blind, sham-controlled trial

Bo Ryun Kim et al. Arch Phys Med Rehabil. 2013 May.

Abstract

Objective: To compare the therapeutic effect of low- and high-frequency repetitive transcranial magnetic stimulation (rTMS) of the posterior parietal cortex (PPC) in patients with acute stroke with visuospatial neglect.

Design: This study was a prospective, double-blind, sham-controlled trial. Data are presented from 27 patients (15 men, 12 women; mean age, 67.0y) randomly assigned to receive 10 sessions of low-frequency (1Hz) rTMS over the nonlesioned PPC, high-frequency (10Hz) rTMS over the lesioned PPC, or sham stimulation.

Setting: National university hospital.

Participants: Patients (N=27) diagnosed with visuospatial neglect after stroke.

Intervention: Ten sessions of rTMS over a 2-week period.

Main outcome measures: The severity of visuospatial neglect was assessed pre- and posttreatment using the Motor-Free Visual Perception Test, line bisection test, star cancellation test, and Catherine Bergego Scale.

Results: When comparing the differences in the Motor-Free Visual Perception Test, line bisection test, star cancellation test, Catherine Bergego Scale, and Korean-Modified Barthel Index (K-MBI) scores before and after treatment according to group, we found that changes in the line bisection test and K-MBI scores were significantly different between 3 groups. In the post hoc analysis, the improvement in the line bisection test score in the high-frequency rTMS group was statistically significant compared with that in the sham stimulation group (high vs sham P=.03, low vs sham P=.09, high vs low P=.58), and the improvements in the K-MBI scores of the 2 rTMS groups were statistically significant compared with those in the sham stimulation group (high vs sham P<.01, low vs sham P=.02, high vs low P=.75).

Conclusions: These results indicate that high-frequency rTMS is effective in the treatment of visuospatial neglect in patients with acute stroke.

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