Magnetic stimulation may improve stroke recovery
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The results of a small preliminary trial suggest that a type of magnetic stimulation of the brain—- repetitive transcranial magnetic stimulation (rTMS)—may produce short-term improvements after Stroke.
With rTMS, the head is placed close to intermittent magnetic fields. No anesthesia is required and the procedure is performed on an outpatient basis. Patients may complain of headaches during rTMS, depending on the strength of the field used.
Previous trials of rTMS used to treat Depression and movement disorders have yielded mixed results, the study investigators note.
In their current study, reported in the medical journal Neurology, Dr. Eman M. Khedr, from Assiut University Hospital in Egypt, and colleagues recruited 52 patients within 5 to 10 days of stroke onset. In addition to standard physical and medical therapies, patients were randomly assigned to 10 daily sessions of rTMS or a fake “sham” treatment.
Stimulation was applied intermittently for 10 minutes over the area of the brain in which the Stroke occurred.
When evaluated 10 days after the last rTMS session, 35 percent of those in the rTMS group and 8 percent in the sham group had a good-to-excellent functional outcome. On the same day, 50 percent of the treatment patients and 19 percent of the sham patients exhibited only mild disability.
However, the six patients in the rTMS group and five in the sham group who had massive Strokes had no improvement associated with treatment.
Strokes are classified as ischemic strokes or hemorrhagic strokes. Ischemic strokes happen when the blood supply to the brain is interrupted. The brain cells then die from lack of oxygen. Hemorrhagic strokes occur when blood vessels in the brain burst and release blood into the area around the brain cells. The blood then damages the brain cells. The products released when cells die cause swelling in the brain. Since the skull doesn’t allow much room for expansion, this swelling can damage the brain tissue even further.
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Conclusions that can be drawn from this study are limited because of the small number of subjects and short duration of follow-up, Dr. Paolo Maria Rossini, at University Campus Biomedico in Rome, and Dr. Claiborne S. Johnston, from the University of California San Francisco, comment in an accompanying editorial.
While lauding this “new avenue of research,” the editorialists suggest that more studies should be conducted with animals before proceeding to human trials.
SOURCE: Neurology, August 9, 2005.
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