Frontiers in Neural Circuits (Oct 2021)

Cerebellar Intermittent Theta-Burst Stimulation Reduces Upper Limb Spasticity After Subacute Stroke: A Randomized Controlled Trial

  • Yi Chen,
  • Yi Chen,
  • Qing-Chuan Wei,
  • Qing-Chuan Wei,
  • Ming-Zhi Zhang,
  • Yun-Juan Xie,
  • Yun-Juan Xie,
  • Ling-Yi Liao,
  • Ling-Yi Liao,
  • Ling-Yi Liao,
  • Hui-Xin Tan,
  • Hui-Xin Tan,
  • Qi-Fan Guo,
  • Qi-Fan Guo,
  • Qiang Gao,
  • Qiang Gao

DOI
https://doi.org/10.3389/fncir.2021.655502
Journal volume & issue
Vol. 15

Abstract

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Objective: This study aims to explore the efficacy of cerebellar intermittent theta-burst stimulation (iTBS) on upper limb spasticity in subacute stroke patients.Methods: A total of 32 patients with upper limb spasticity were enrolled and randomly assigned to treatment with cerebellar iTBS or sham stimulation before conventional physical therapy daily for 2 weeks. The primary outcomes included the modified Ashworth scale (MAS), the modified Tardieu scale (MTS), and the shear wave velocity (SWV). The secondary outcomes were the H-maximum wave/M-maximum wave amplitude ratio (Hmax/Mmax ratio), motor-evoked potential (MEP) latency and amplitude, central motor conduction time (CMCT), and the Barthel Index (BI). All outcomes were evaluated at baseline and after 10 sessions of intervention.Results: After the intervention, both groups showed significant improvements in the MAS, MTS, SWV, and BI. In addition, patients treated with cerebellar iTBS had a significant increase in MEP amplitude, and patients treated with sham stimulation had a significant decrease in Hmax/Mmax ratio. Compared with the sham stimulation group, the MAS, MTS, and SWV decreased more in the cerebellar iTBS group.Conclusion: Cerebellar iTBS is a promising adjuvant tool to reinforce the therapeutic effect of conventional physical therapy in upper limb spasticity management after subacute stroke (Chinese Clinical Trial Registry: ChiCTR1900026516).

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