Function-specific repetitive transcranial magnetic stimulation for fine motor rehabilitation in chronic stroke: a case report

TL;DR

A chronic stroke patient improved hand motor skills after a new type of brain stimulation guided by brain scans.

Contribution

A novel function-specific rTMS approach guided by fMRI is proposed for fine motor rehabilitation in chronic stroke.

Findings

A chronic stroke patient showed significant fine motor improvement after 8 weeks of function-specific rTMS.

Electrophysiological and MRI data suggested restored interhemispheric functional balance.

The intervention was effective even years after the initial stroke.

Abstract

Although repetitive transcranial magnetic stimulation (rTMS) has been widely used in the treatment of post-stroke hemiparesis, its efficacy in restoring fine motor function of the hand remains limited, largely because of a lack of specificity in target selection. This study presents the case of a 61-year-old female chronic stroke patient who showed significant improvement in hand fine motor function following an 8-week intervention using function-specific rTMS guided by functional magnetic resonance imaging (fMRI). The patient previously experienced multiple lacunar infarctions in the bilateral basal ganglia and centrum semiovale and received the intervention 4 years after the stroke. Following treatment, substantial improvements were observed in fine motor function, with electrophysiological and MRI findings indicating a trend toward restored interhemispheric functional balance. This case highlights a novel therapeutic approach for patients who have shown limited responses to conventional rehabilitation.

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