Ultra-early navigated transcranial magnetic stimulation for perioperative stroke: anatomo-functional report

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 - https://www.scopus.com/pages/publications/85196239061

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 -