Author: León Ruiz M1, Rodríguez Sarasa ML2, Sanjuán Rodríguez L3, Benito-León J4, García-Albea Ristol E5, Arce Arce S6
Affiliation:
1Servicio de Neurología, Clínica San Vicente, Madrid, España. Electronic address: pistolpete271285@hotmail.com.
2Servicio de Medicina Interna, Clínica San Vicente, Madrid, España; Departamento de Gerencia, Clínica San Vicente, Madrid, España.
3Departamento de Dirección de Gestión Sanitaria, Clínica San Vicente, Madrid, España.
4Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, España.
5Servicio de Neurología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España.
6Servicio de Psiquiatría, Clínica San Vicente, Madrid, España; Departamento de Dirección Médica, Clínica San Vicente, Madrid, España.
Conference/Journal: Neurologia.
Date published: 2016 May 6
Other:
Pages: S0213-4853(16)30030-5 , Special Notes: doi: 10.1016/j.nrl.2016.03.008. [Epub ahead of print] [Article in English, Spanish] , Word Count: 263
INTRODUCTION: Repetitive transcranial magnetic stimulation (rTMS) is a therapeutic reality in post-stroke rehabilitation. It has a neuroprotective effect on the modulation of neuroplasticity, improving the brain's capacity to retrain neural circuits and promoting restoration and acquisition of new compensatory skills.
DEVELOPMENT: We conducted a literature search on PubMed and also gathered the latest books, clinical practice guidelines, and recommendations published by the most prominent scientific societies concerning the therapeutic use of rTMS in the rehabilitation of stroke patients. The criteria of the International Federation of Clinical Neurophysiology (2014) were followed regarding the inclusion of all evidence and recommendations.
CONCLUSIONS: Identifying stroke patients who are eligible for rTMS is essential to accelerate their recovery. rTMS has proven to be safe and effective for treating stroke complications. Functional brain activity can be optimised by applying excitatory or inhibitory electromagnetic pulses to the hemisphere ipsilateral or contralateral to the lesion, respectively, as well as at the level of the transcallosal pathway to regulate interhemispheric communication. Different studies of rTMS in these patients have resulted in improvements in motor disorders, aphasia, dysarthria, oropharyngeal dysphagia, and perceptual-cognitive deficits. However, further well-designed randomized controlled clinical trials with larger sample size are needed to recommend with a higher level of evidence, proper implementation of rTMS use in stroke subjects on a widespread basis.
Copyright © 2016 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.
KEYWORDS: Afasia; Aphasia; Disfagia; Dysphagia; Estimulación magnética transcraneal; Ictus; Neuroplasticidad; Neuroplasticity; Neurorehabilitation; Neurorrehabilitación; Stroke; Transcranial magnetic stimulation
PMID: 27161423 [PubMed - as supplied by publisher] Free full text
