TY - JOUR
T1 - Ultra-early navigated transcranial magnetic stimulation for perioperative stroke
T2 - anatomo-functional report
AU - Lavrador, José Pedro
AU - Rajwani, Kapil
AU - Patel, Sabina
AU - Kalaitzoglou, Dimitrios
AU - Soumpasis, Christos
AU - Gullan, Richard
AU - Ashkan, Keyoumars
AU - Bhangoo, Ranjeev
AU - Dell'acqua, Flavio
AU - Vergani, Francesco
N1 - Publisher Copyright:
© 2024 The Author(s). Published by Oxford University Press. All rights reserved.
PY - 2024/6/16
Y1 - 2024/6/16
N2 - Navigated repetitive transmagnetic stimulation is a non-invasive and safe brain activity modulation technique. When combined with the classical rehabilitation process in stroke patients it has the potential to enhance the overall neurologic recovery. We present a case of a peri-operative stroke, treated with ultra-early low frequency navigated repetitive transmagnetic stimulation over the contralesional hemisphere. The patient received low frequency navigated repetitive transmagnetic stimulation within 12 hours of stroke onset for seven consecutive days and a significant improvement in his right sided weakness was noticed and he was discharge with normal power. This was accompanied by an increase in the number of positive responses evoked by navigated repetitive transmagnetic stimulation and a decrease of the resting motor thresholds at a cortical level. Subcortically, a decrease in the radial, axial, and mean diffusivity were recorded in the ipsilateral corticospinal tract and an increase in fractional anisotropy, axial diffusivity, and mean diffusivity was observed in the interhemispheric fibers of the corpus callosum responsible for the interhemispheric connectivity between motor areas. Our case demonstrates clearly that ultra-early low frequency navigated repetitive transmagnetic stimulation applied to the contralateral motor cortex can lead to significant clinical motor improvement in patients with subcortical stroke.
AB - Navigated repetitive transmagnetic stimulation is a non-invasive and safe brain activity modulation technique. When combined with the classical rehabilitation process in stroke patients it has the potential to enhance the overall neurologic recovery. We present a case of a peri-operative stroke, treated with ultra-early low frequency navigated repetitive transmagnetic stimulation over the contralesional hemisphere. The patient received low frequency navigated repetitive transmagnetic stimulation within 12 hours of stroke onset for seven consecutive days and a significant improvement in his right sided weakness was noticed and he was discharge with normal power. This was accompanied by an increase in the number of positive responses evoked by navigated repetitive transmagnetic stimulation and a decrease of the resting motor thresholds at a cortical level. Subcortically, a decrease in the radial, axial, and mean diffusivity were recorded in the ipsilateral corticospinal tract and an increase in fractional anisotropy, axial diffusivity, and mean diffusivity was observed in the interhemispheric fibers of the corpus callosum responsible for the interhemispheric connectivity between motor areas. Our case demonstrates clearly that ultra-early low frequency navigated repetitive transmagnetic stimulation applied to the contralateral motor cortex can lead to significant clinical motor improvement in patients with subcortical stroke.
KW - corticospinal tract
KW - fractional anisotropy
KW - perioperative stroke
KW - resting motor threshold
KW - transcranial magnetic stimulation
UR - http://www.scopus.com/inward/record.url?scp=85196239061&partnerID=8YFLogxK
U2 - 10.1093/cercor/bhae251
DO - 10.1093/cercor/bhae251
M3 - Article
C2 - 38879808
AN - SCOPUS:85196239061
SN - 1047-3211
VL - 34
JO - Cerebral Cortex
JF - Cerebral Cortex
IS - 6
M1 - bhae251
ER -
