Are you a stroke patient who suffers from issues with arm or hand movement? You may have heard that a therapy called Transcranial Magnetic Stimulation, or TMS, could potentially help you.
Motor deficits from a stroke aren’t only due to the damage done to nerve cells. They are also caused by changes in the actual organization of nerve networks. Strokes can change the way the two halves of the brain communicate. For some time, scientists thought that the two sides of the brain were always competing against each other. They believed that when one half got stronger, the other got weaker. In a stroke, one side is usually more affected than the other. Researchers thought that perhaps decreasing activity on the healthier, unaffected side could improve the area affected by a stroke. However, results of this type of treatment have been mixed. It’s unclear whether or not this works to help stroke patients.
A review of TMS
In light of this theory, the most commonly used stroke treatment is TMS. Scientists from Italy and the US decided to evaluate the true benefit of TMS and the validity of this theory. They reviewed 11 studies, published between 2007 and 2017, that investigated this type of treatment and its effects on arm-hand function.
While most of the selected articles showed results correlating to the theory of rivalry between the brain halves, it turns out that 4 of the 11 studies conducted did not support this theory. Researchers share several suspected reasons for why. They found that age played a factor. The older the patient was, the less beneficial it was to lessen the activity in the healthy side of the brain. Additionally, the theory didn’t seem to apply for patients who were in the chronic phase of their stroke recovery. There were other key factors as well. Things such as the settings on the equipment used or the location of the stroke seemed to influence the effectiveness of this type of therapy.
The researchers found that the most critical factor when considering this therapy was the level of motor function that the patient has before starting TMS. If you have good motor function, you will likely be able to benefit from this type of therapy more. However, those with poor motor function see less improvement. Instead, these patients could benefit from other types of treatment.
Factors influencing TMS
Scientific studies show real benefits. However, there are many factors that can influence whether this treatment is going to be effective. If you’re older or are currently in the chronic phase, this type of therapy might be less effective. Furthermore, if you are suffering from severe deficits in motor function, decreasing brain activity in the unaffected side probably won’t be effective for you either. This type of therapy should be reserved for those who have recently suffered a stroke, are younger, and have retained relatively good motor function overall. If you’re interested to know more about this therapy option, talk with your medical team for a professional opinion.
The first author of this study is Federica Bertolucci, from the Department of Neuroscience, Unit of Neurorehabilitation at the University Hospital of Pisa, Italy.