Evidence map›Paper›PMID 31227676›Full record

ArticleRestorative neurology and neuroscience2019

The effects of five sessions of continuous theta burst stimulation over contralesional sensorimotor cortex paired with paretic skilled motor practice in people with chronic stroke.

J L Neva, K E Brown, K P Wadden, C S Mang, M R Borich, S K Meehan, L A Boyd

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Restorative neurology and neuroscience, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
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  8. Article
  9. Study Paradigms and Principles Investigated in Motor Learning Research After Stroke: A Scoping Review.Archives of rehabilitation research and clinical translation · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

J L NevaDepartment of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
K E BrownGraduate Studies in Rehabilitation Sciences, University of British Columbia, Vancouver Canada.
K P WaddenGraduate Studies in Rehabilitation Sciences, University of British Columbia, Vancouver Canada.
C S MangGraduate Studies in Rehabilitation Sciences, University of British Columbia, Vancouver Canada.
M R BorichDepartment of Rehabilitation Medicine, Division of Physical Therapy, School of Medicine, Emory University, Atlanta, GA, USA.
S K MeehanSchool of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA.
L A BoydDepartment of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

Funding

Research Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Neil Alexander · 2004 to 2026
$29.2M
MULTICENTER CAREER DEVELOPMENT PROGRAM FOR PHYSICAL AND OCCUPATIONAL THERAPYK12HD055931 · NICHD · WASHINGTON UNIVERSITY · PI HAYES, MARCIE HARRIS · 2007 to 2021
$12.7M
CIHR MOP-106651NIA NIH HHS P30 AG024824NICHD NIH HHS K12 HD055931
6 · The paper itself

Abstract

backgroundIn individuals with chronic stroke, impairment of the paretic arm may be exacerbated by increased contralesional transcallosal inhibition (TCI). Continuous theta burst stimulation (cTBS) can decrease primary motor cortex (M1) excitability and TCI. However, contralesional cTBS shows inconsistent effects after stroke. Variable effects of cTBS could stem from failure to pair stimulation with skilled motor practice or a focus of applying cTBS over M1.

objectiveHere, we investigated the effects of pairing cTBS with skilled practice on motor learning and arm function. We considered the differential effects of stimulation over two different brain regions: contralesional M1 (M1c) or contralesional primary somatosensory cortex (S1c).

methods37 individuals with chronic stroke participated in five sessions of cTBS and paretic arm skilled practice of a serial targeting task (STT); participants received either cTBS over M1c or S1c or sham before STT practice. Changes in STT performance and Wolf Motor Function Test (WMFT) were assessed as primary outcomes. Assessment of bilateral corticospinal, intracortical excitability and TCI were secondary outcomes.

resultscTBS over sensorimotor cortex did not improve STT performance and paretic WMFT-rate beyond sham cTBS. TCI was reduced bi-directionally following the intervention, regardless of stimulation group. In addition, we observed an association between STT performance change and paretic WMFT-rate change in the M1c stimulation group only.

conclusionsMultiple sessions of STT practice can improve paretic arm function and decrease TCI bilaterally, with no additional benefit of prior cTBS. Our results suggest that improvement in STT practice following M1c cTBS scaled with change in paretic arm function in some individuals. Our results highlight the need for a better understanding of the mechanisms of cTBS to effectively identify who may benefit from this form of brain stimulation.

Indexed as

Practice, PsychologicalStroke RehabilitationTranscranial Magnetic StimulationAgedArmChronic DiseaseCorpus CallosumCortical ExcitabilityFemaleHumansMaleMiddle AgedMotor CortexMotor SkillsNeural InhibitionParesiscontinuous theta burst stimulationmotor functionskilled motor practiceStroketranscallosal inhibitiontranscranial magnetic stimulation

Identifiers

PMID31227676
PMCPMC7886006

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.