Effects of Repetitive Transcranial Magnetic Stimulation on Hand Function Recovery and Excitability of the Motor Cortex After Stroke

Objective The purpose of this article was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on hand function recovery and the plasticity of the cortex in stroke patients. Design A search was conducted in electronic databases for randomized controlled trials exploring the effects of rTMS on hand motor function rehabilitation published from 1990 to January 30, 2012. The authors summarized the effect size on finger coordination, hand function, cortical excitement, and activities of daily living by calculating the standardized mean difference. Adverse effects were also discussed. Results Of 1668 articles identified, 8 articles (N = 273) were included in this study. The summary effect size indicated positive effects of rTMS on finger motor ability (standardized mean difference, 0.58) and hand function (standardized mean difference, -0.82). However, this study showed that the changes of neurophysiologic measurements were not significant in the included studies. Even so, the trend of these changes was positive. Few adverse events were observed. Conclusions rTMS can improve patients' recovery after stroke. The authors suggest that future trials can concentrate on the effects of rTMS for different types of stroke patients in response to stimulation at different sites and explore optimal rTMS parameters for individual treatment.