# 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.

## Key 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.