Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective
BackgroundRehabilitation is critical for reducing stroke-related disability and improving quality-of-life post-stroke. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique used as stand-alone or adjunct treatment to physiotherapy, may be of benefit for motor...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-02-01
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| Series: | Frontiers in Rehabilitation Sciences |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fresc.2022.795335/full |
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| author | Franziska E. Hildesheim Franziska E. Hildesheim Franziska E. Hildesheim Alexander N. Silver Alexander N. Silver Alexander N. Silver Adan-Ulises Dominguez-Vargas Adan-Ulises Dominguez-Vargas Adan-Ulises Dominguez-Vargas Justin W. Andrushko Justin W. Andrushko Jodi D. Edwards Jodi D. Edwards Jodi D. Edwards Numa Dancause Numa Dancause Numa Dancause Alexander Thiel Alexander Thiel Alexander Thiel |
| author_facet | Franziska E. Hildesheim Franziska E. Hildesheim Franziska E. Hildesheim Alexander N. Silver Alexander N. Silver Alexander N. Silver Adan-Ulises Dominguez-Vargas Adan-Ulises Dominguez-Vargas Adan-Ulises Dominguez-Vargas Justin W. Andrushko Justin W. Andrushko Jodi D. Edwards Jodi D. Edwards Jodi D. Edwards Numa Dancause Numa Dancause Numa Dancause Alexander Thiel Alexander Thiel Alexander Thiel |
| author_sort | Franziska E. Hildesheim |
| collection | DOAJ |
| description | BackgroundRehabilitation is critical for reducing stroke-related disability and improving quality-of-life post-stroke. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique used as stand-alone or adjunct treatment to physiotherapy, may be of benefit for motor recovery in subgroups of stroke patients. The Canadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim) seeks to advance the use of these techniques to improve post-stroke recovery through clinical trials and pre-clinical studies using standardized research protocols. Here, we review existing clinical trials for demographic, clinical, and neurobiological factors which may predict treatment response to identify knowledge gaps which need to be addressed before implementing these parameters for patient stratification in clinical trial protocols.ObjectiveTo provide a review of clinical rTMS trials of stroke recovery identifying factors associated with rTMS response in stroke patients with motor deficits and develop research perspectives for pre-clinical and clinical studies.MethodsA literature search was performed in PubMed, using the Boolean search terms stroke AND repetitive transcranial magnetic stimulation OR rTMS AND motor for studies investigating the use of rTMS for motor recovery in stroke patients at any recovery phase. A total of 1,676 articles were screened by two blinded raters, with 26 papers identified for inclusion in this review.ResultsMultiple possible factors associated with rTMS response were identified, including stroke location, cortical thickness, brain-derived neurotrophic factor (BDNF) genotype, initial stroke severity, and several imaging and clinical factors associated with a relatively preserved functional motor network of the ipsilesional hemisphere. Age, sex, and time post-stroke were generally not related to rTMS response. Factors associated with greater response were identified in studies of both excitatory ipsilesional and inhibitory contralesional rTMS. Heterogeneous study designs and contradictory data exemplify the need for greater protocol standardization and high-quality controlled trials.ConclusionClinical, brain structural and neurobiological factors have been identified as potential predictors for rTMS response in stroke patients with motor impairment. These factors can inform the design of future clinical trials, before being considered for optimization of individual rehabilitation therapy for stroke patients. Pre-clinical models for stroke recovery, specifically developed in a clinical context, may accelerate this process. |
| first_indexed | 2024-04-11T03:26:14Z |
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| id | doaj.art-c99cd730565843d78e79cda7b5dbf3c2 |
| institution | Directory Open Access Journal |
| issn | 2673-6861 |
| language | English |
| last_indexed | 2024-04-11T03:26:14Z |
| publishDate | 2022-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Rehabilitation Sciences |
| spelling | doaj.art-c99cd730565843d78e79cda7b5dbf3c22023-01-02T07:26:44ZengFrontiers Media S.A.Frontiers in Rehabilitation Sciences2673-68612022-02-01310.3389/fresc.2022.795335795335Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim PerspectiveFranziska E. Hildesheim0Franziska E. Hildesheim1Franziska E. Hildesheim2Alexander N. Silver3Alexander N. Silver4Alexander N. Silver5Adan-Ulises Dominguez-Vargas6Adan-Ulises Dominguez-Vargas7Adan-Ulises Dominguez-Vargas8Justin W. Andrushko9Justin W. Andrushko10Jodi D. Edwards11Jodi D. Edwards12Jodi D. Edwards13Numa Dancause14Numa Dancause15Numa Dancause16Alexander Thiel17Alexander Thiel18Alexander Thiel19Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, CanadaCanadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim), Montréal, QC, CanadaDepartment of Neurology and Neurosurgery, McGill University, Montréal, QC, CanadaLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, CanadaCanadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim), Montréal, QC, CanadaDepartment of Neurology and Neurosurgery, McGill University, Montréal, QC, CanadaCanadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim), Montréal, QC, CanadaCentre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montréal, QC, CanadaDépartement de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, QC, CanadaCanadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim), Montréal, QC, CanadaDepartment of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, CanadaCanadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim), Montréal, QC, CanadaUniversity of Ottawa Heart Institute, Ottawa, ON, CanadaSchool of Epidemiology and Public Health, University of Ottawa Heart Institute, Ottawa, ON, CanadaCanadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim), Montréal, QC, CanadaCentre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montréal, QC, CanadaDépartement de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, QC, CanadaLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, CanadaCanadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim), Montréal, QC, CanadaDepartment of Neurology and Neurosurgery, McGill University, Montréal, QC, CanadaBackgroundRehabilitation is critical for reducing stroke-related disability and improving quality-of-life post-stroke. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique used as stand-alone or adjunct treatment to physiotherapy, may be of benefit for motor recovery in subgroups of stroke patients. The Canadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim) seeks to advance the use of these techniques to improve post-stroke recovery through clinical trials and pre-clinical studies using standardized research protocols. Here, we review existing clinical trials for demographic, clinical, and neurobiological factors which may predict treatment response to identify knowledge gaps which need to be addressed before implementing these parameters for patient stratification in clinical trial protocols.ObjectiveTo provide a review of clinical rTMS trials of stroke recovery identifying factors associated with rTMS response in stroke patients with motor deficits and develop research perspectives for pre-clinical and clinical studies.MethodsA literature search was performed in PubMed, using the Boolean search terms stroke AND repetitive transcranial magnetic stimulation OR rTMS AND motor for studies investigating the use of rTMS for motor recovery in stroke patients at any recovery phase. A total of 1,676 articles were screened by two blinded raters, with 26 papers identified for inclusion in this review.ResultsMultiple possible factors associated with rTMS response were identified, including stroke location, cortical thickness, brain-derived neurotrophic factor (BDNF) genotype, initial stroke severity, and several imaging and clinical factors associated with a relatively preserved functional motor network of the ipsilesional hemisphere. Age, sex, and time post-stroke were generally not related to rTMS response. Factors associated with greater response were identified in studies of both excitatory ipsilesional and inhibitory contralesional rTMS. Heterogeneous study designs and contradictory data exemplify the need for greater protocol standardization and high-quality controlled trials.ConclusionClinical, brain structural and neurobiological factors have been identified as potential predictors for rTMS response in stroke patients with motor impairment. These factors can inform the design of future clinical trials, before being considered for optimization of individual rehabilitation therapy for stroke patients. Pre-clinical models for stroke recovery, specifically developed in a clinical context, may accelerate this process.https://www.frontiersin.org/articles/10.3389/fresc.2022.795335/fullrepetitive transcranial magnetic stimulationstrokemotor recoveryrehabilitationpredictionreview |
| spellingShingle | Franziska E. Hildesheim Franziska E. Hildesheim Franziska E. Hildesheim Alexander N. Silver Alexander N. Silver Alexander N. Silver Adan-Ulises Dominguez-Vargas Adan-Ulises Dominguez-Vargas Adan-Ulises Dominguez-Vargas Justin W. Andrushko Justin W. Andrushko Jodi D. Edwards Jodi D. Edwards Jodi D. Edwards Numa Dancause Numa Dancause Numa Dancause Alexander Thiel Alexander Thiel Alexander Thiel Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective Frontiers in Rehabilitation Sciences repetitive transcranial magnetic stimulation stroke motor recovery rehabilitation prediction review |
| title | Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective |
| title_full | Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective |
| title_fullStr | Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective |
| title_full_unstemmed | Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective |
| title_short | Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective |
| title_sort | predicting individual treatment response to rtms for motor recovery after stroke a review and the canstim perspective |
| topic | repetitive transcranial magnetic stimulation stroke motor recovery rehabilitation prediction review |
| url | https://www.frontiersin.org/articles/10.3389/fresc.2022.795335/full |
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