Monophasic-Quadripulse Theta Burst Magnetic Stimulation for Motor Palsy Functional Evaluation After Intracerebral Hemorrhage
Transcranial magnetic stimulation (TMS) is commonly employed for diagnostic and therapeutic purposes to enhance recovery following brain injury, such as stroke or intracerebral hemorrhage (ICH). Single-pulse TMS, most commonly used for diagnostic purposes and with motor evoked potential (MEP) record...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-03-01
|
| Series: | Frontiers in Integrative Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnint.2022.827518/full |
| _version_ | 1818319177478307840 |
|---|---|
| author | Minoru Fujiki Wataru Matsushita Yukari Kawasaki Hirotaka Fudaba |
| author_facet | Minoru Fujiki Wataru Matsushita Yukari Kawasaki Hirotaka Fudaba |
| author_sort | Minoru Fujiki |
| collection | DOAJ |
| description | Transcranial magnetic stimulation (TMS) is commonly employed for diagnostic and therapeutic purposes to enhance recovery following brain injury, such as stroke or intracerebral hemorrhage (ICH). Single-pulse TMS, most commonly used for diagnostic purposes and with motor evoked potential (MEP) recordings, is not suitable for clinical use in patients with severe motor paresis. To overcome this problem, we developed a quadripulse theta burst transcranial magnetic stimulation (QTS) device that combines the output from 16 stimulators to deliver a train of 16 monophasic magnetic pulses through a single coil. High-frequency theta rhythm magnetic bursts (bursts of four monophasic pulses, at 500 Hz, i.e., with a 2-ms interpulse interval, repeated at 5 Hz) were generated via a set of 16 separate magnetic stimulators connected to a specially designed combination module. No adverse effects or electroencephalogram (EEGs) abnormalities were identified during or after the recordings. MEP amplification in the QTS during four-burst theta rhythm stimulations produced four independent MEPs 20 ms after each burst onset maximizing the final third or fourth burst, which exhibited significantly greater amplitude than those resulting from a single burst or pulse. Motor functional palsy grades after ICH and QTS-MEP parameters and resting motor threshold (RMT) and amplitudes were significantly correlated (r = −0.83/−0.81 and 0.89/0.87; R2 = 0.69/0.66 and 0.79/0.76, p < 0.001; anterior/posterior-stimulus polarity, respectively). In conclusion, QTS-MEPs enabled a linear functional evaluation in patients with various degrees of motor paresis. However, the benefits, safety, and limitations of this device should be further explored in future studies. |
| first_indexed | 2024-12-13T10:04:58Z |
| format | Article |
| id | doaj.art-ca58a8b15eb8486382b82b479ba32f9e |
| institution | Directory Open Access Journal |
| issn | 1662-5145 |
| language | English |
| last_indexed | 2024-12-13T10:04:58Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Integrative Neuroscience |
| spelling | doaj.art-ca58a8b15eb8486382b82b479ba32f9e2022-12-21T23:51:34ZengFrontiers Media S.A.Frontiers in Integrative Neuroscience1662-51452022-03-011610.3389/fnint.2022.827518827518Monophasic-Quadripulse Theta Burst Magnetic Stimulation for Motor Palsy Functional Evaluation After Intracerebral HemorrhageMinoru FujikiWataru MatsushitaYukari KawasakiHirotaka FudabaTranscranial magnetic stimulation (TMS) is commonly employed for diagnostic and therapeutic purposes to enhance recovery following brain injury, such as stroke or intracerebral hemorrhage (ICH). Single-pulse TMS, most commonly used for diagnostic purposes and with motor evoked potential (MEP) recordings, is not suitable for clinical use in patients with severe motor paresis. To overcome this problem, we developed a quadripulse theta burst transcranial magnetic stimulation (QTS) device that combines the output from 16 stimulators to deliver a train of 16 monophasic magnetic pulses through a single coil. High-frequency theta rhythm magnetic bursts (bursts of four monophasic pulses, at 500 Hz, i.e., with a 2-ms interpulse interval, repeated at 5 Hz) were generated via a set of 16 separate magnetic stimulators connected to a specially designed combination module. No adverse effects or electroencephalogram (EEGs) abnormalities were identified during or after the recordings. MEP amplification in the QTS during four-burst theta rhythm stimulations produced four independent MEPs 20 ms after each burst onset maximizing the final third or fourth burst, which exhibited significantly greater amplitude than those resulting from a single burst or pulse. Motor functional palsy grades after ICH and QTS-MEP parameters and resting motor threshold (RMT) and amplitudes were significantly correlated (r = −0.83/−0.81 and 0.89/0.87; R2 = 0.69/0.66 and 0.79/0.76, p < 0.001; anterior/posterior-stimulus polarity, respectively). In conclusion, QTS-MEPs enabled a linear functional evaluation in patients with various degrees of motor paresis. However, the benefits, safety, and limitations of this device should be further explored in future studies.https://www.frontiersin.org/articles/10.3389/fnint.2022.827518/fullcorticospinal tractmagnetic stimulationquadripulse theta burst stimulationmulti train stimulationmotor-evoked potentialsquadripulse stimulation |
| spellingShingle | Minoru Fujiki Wataru Matsushita Yukari Kawasaki Hirotaka Fudaba Monophasic-Quadripulse Theta Burst Magnetic Stimulation for Motor Palsy Functional Evaluation After Intracerebral Hemorrhage Frontiers in Integrative Neuroscience corticospinal tract magnetic stimulation quadripulse theta burst stimulation multi train stimulation motor-evoked potentials quadripulse stimulation |
| title | Monophasic-Quadripulse Theta Burst Magnetic Stimulation for Motor Palsy Functional Evaluation After Intracerebral Hemorrhage |
| title_full | Monophasic-Quadripulse Theta Burst Magnetic Stimulation for Motor Palsy Functional Evaluation After Intracerebral Hemorrhage |
| title_fullStr | Monophasic-Quadripulse Theta Burst Magnetic Stimulation for Motor Palsy Functional Evaluation After Intracerebral Hemorrhage |
| title_full_unstemmed | Monophasic-Quadripulse Theta Burst Magnetic Stimulation for Motor Palsy Functional Evaluation After Intracerebral Hemorrhage |
| title_short | Monophasic-Quadripulse Theta Burst Magnetic Stimulation for Motor Palsy Functional Evaluation After Intracerebral Hemorrhage |
| title_sort | monophasic quadripulse theta burst magnetic stimulation for motor palsy functional evaluation after intracerebral hemorrhage |
| topic | corticospinal tract magnetic stimulation quadripulse theta burst stimulation multi train stimulation motor-evoked potentials quadripulse stimulation |
| url | https://www.frontiersin.org/articles/10.3389/fnint.2022.827518/full |
| work_keys_str_mv | AT minorufujiki monophasicquadripulsethetaburstmagneticstimulationformotorpalsyfunctionalevaluationafterintracerebralhemorrhage AT watarumatsushita monophasicquadripulsethetaburstmagneticstimulationformotorpalsyfunctionalevaluationafterintracerebralhemorrhage AT yukarikawasaki monophasicquadripulsethetaburstmagneticstimulationformotorpalsyfunctionalevaluationafterintracerebralhemorrhage AT hirotakafudaba monophasicquadripulsethetaburstmagneticstimulationformotorpalsyfunctionalevaluationafterintracerebralhemorrhage |