Low-frequency repetitive transcranial magnetic stimulation in patients with motor deficits after brain tumor resection: a randomized, double-blind, sham-controlled trial
ObjectiveSurgical resection of motor eloquent tumors poses the risk of causing postoperative motor deficits which leads to reduced quality of life in these patients. Currently, rehabilitative procedures are limited with physical therapy being the main treatment option. This study investigated the ef...
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| Format: | Article |
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Frontiers Media S.A.
2024-04-01
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| Serier: | Frontiers in Oncology |
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| Online adgang: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1368924/full |
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| author | Melina Engelhardt Melina Engelhardt Melina Engelhardt Heike Schneider Jan Reuther Ulrike Grittner Peter Vajkoczy Thomas Picht Thomas Picht Thomas Picht Tizian Rosenstock Tizian Rosenstock |
| author_facet | Melina Engelhardt Melina Engelhardt Melina Engelhardt Heike Schneider Jan Reuther Ulrike Grittner Peter Vajkoczy Thomas Picht Thomas Picht Thomas Picht Tizian Rosenstock Tizian Rosenstock |
| author_sort | Melina Engelhardt |
| collection | DOAJ |
| description | ObjectiveSurgical resection of motor eloquent tumors poses the risk of causing postoperative motor deficits which leads to reduced quality of life in these patients. Currently, rehabilitative procedures are limited with physical therapy being the main treatment option. This study investigated the efficacy of repetitive navigated transcranial magnetic stimulation (rTMS) for treatment of motor deficits after supratentorial tumor resection.MethodsThis randomized, double-blind, sham-controlled trial (DRKS00010043) recruited patients with a postoperatively worsened upper extremity motor function immediately postoperatively. They were randomly assigned to receive rTMS (1Hz, 110% RMT, 15 minutes, 7 days) or sham stimulation to the motor cortex contralateral to the injury followed by physical therapy. Motor and neurological function as well as quality of life were assessed directly after the intervention, one month and three months postoperatively.ResultsThirty patients were recruited for this study. There was no significant difference between both groups in the primary outcome, the Fugl Meyer score three months postoperatively [Group difference (95%-CI): 5.05 (-16.0; 26.1); p=0.631]. Patients in the rTMS group presented with better hand motor function one month postoperatively. Additionally, a subgroup of patients with motor eloquent ischemia showed lower NIHSS scores at all timepoints.ConclusionsLow-frequency rTMS facilitated the recovery process in stimulated hand muscles, but with limited generalization to other functional deficits. Long-term motor deficits were not impacted by rTMS. Given the reduced life expectancy in these patients a shortened recovery duration of deficits can still be of high significance.Clinical Trial Registrationhttps://drks.de/DRKS00010043. |
| first_indexed | 2025-03-22T06:23:49Z |
| format | Article |
| id | doaj.art-7b610078b28f47e9ab0c82bccb51e22b |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2025-03-22T06:23:49Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-7b610078b28f47e9ab0c82bccb51e22b2024-04-26T04:57:55ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-04-011410.3389/fonc.2024.13689241368924Low-frequency repetitive transcranial magnetic stimulation in patients with motor deficits after brain tumor resection: a randomized, double-blind, sham-controlled trialMelina Engelhardt0Melina Engelhardt1Melina Engelhardt2Heike Schneider3Jan Reuther4Ulrike Grittner5Peter Vajkoczy6Thomas Picht7Thomas Picht8Thomas Picht9Tizian Rosenstock10Tizian Rosenstock11Department of Neurosurgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyEinstein Center for Neurosciences, Charité – Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyInternational Graduate Program Medical Neurosciences, Charité – Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment for Physical Medicine, Charité -Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyInstitute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyEinstein Center for Neurosciences, Charité – Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyCluster of Excellence Matters of Activity, Image Space Material, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyBerlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin Institute of Health (BIH) Biomedical Innovation Academy, Berlin Institute of Health (BIH) Charité Digital Clinician Scientist Program, Berlin, GermanyObjectiveSurgical resection of motor eloquent tumors poses the risk of causing postoperative motor deficits which leads to reduced quality of life in these patients. Currently, rehabilitative procedures are limited with physical therapy being the main treatment option. This study investigated the efficacy of repetitive navigated transcranial magnetic stimulation (rTMS) for treatment of motor deficits after supratentorial tumor resection.MethodsThis randomized, double-blind, sham-controlled trial (DRKS00010043) recruited patients with a postoperatively worsened upper extremity motor function immediately postoperatively. They were randomly assigned to receive rTMS (1Hz, 110% RMT, 15 minutes, 7 days) or sham stimulation to the motor cortex contralateral to the injury followed by physical therapy. Motor and neurological function as well as quality of life were assessed directly after the intervention, one month and three months postoperatively.ResultsThirty patients were recruited for this study. There was no significant difference between both groups in the primary outcome, the Fugl Meyer score three months postoperatively [Group difference (95%-CI): 5.05 (-16.0; 26.1); p=0.631]. Patients in the rTMS group presented with better hand motor function one month postoperatively. Additionally, a subgroup of patients with motor eloquent ischemia showed lower NIHSS scores at all timepoints.ConclusionsLow-frequency rTMS facilitated the recovery process in stimulated hand muscles, but with limited generalization to other functional deficits. Long-term motor deficits were not impacted by rTMS. Given the reduced life expectancy in these patients a shortened recovery duration of deficits can still be of high significance.Clinical Trial Registrationhttps://drks.de/DRKS00010043.https://www.frontiersin.org/articles/10.3389/fonc.2024.1368924/fullrepetitive transcranial magnetic stimulationmotor deficitgliomarehabilitationpostoperative |
| spellingShingle | Melina Engelhardt Melina Engelhardt Melina Engelhardt Heike Schneider Jan Reuther Ulrike Grittner Peter Vajkoczy Thomas Picht Thomas Picht Thomas Picht Tizian Rosenstock Tizian Rosenstock Low-frequency repetitive transcranial magnetic stimulation in patients with motor deficits after brain tumor resection: a randomized, double-blind, sham-controlled trial Frontiers in Oncology repetitive transcranial magnetic stimulation motor deficit glioma rehabilitation postoperative |
| title | Low-frequency repetitive transcranial magnetic stimulation in patients with motor deficits after brain tumor resection: a randomized, double-blind, sham-controlled trial |
| title_full | Low-frequency repetitive transcranial magnetic stimulation in patients with motor deficits after brain tumor resection: a randomized, double-blind, sham-controlled trial |
| title_fullStr | Low-frequency repetitive transcranial magnetic stimulation in patients with motor deficits after brain tumor resection: a randomized, double-blind, sham-controlled trial |
| title_full_unstemmed | Low-frequency repetitive transcranial magnetic stimulation in patients with motor deficits after brain tumor resection: a randomized, double-blind, sham-controlled trial |
| title_short | Low-frequency repetitive transcranial magnetic stimulation in patients with motor deficits after brain tumor resection: a randomized, double-blind, sham-controlled trial |
| title_sort | low frequency repetitive transcranial magnetic stimulation in patients with motor deficits after brain tumor resection a randomized double blind sham controlled trial |
| topic | repetitive transcranial magnetic stimulation motor deficit glioma rehabilitation postoperative |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1368924/full |
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