Effect of Repetitive Transcranial Magnetic Stimulation on Upper Extremity Function in Stroke Patients : Literature Review

Stroke is one of the main causes of death and disability in adults, and after stroke, patients are left with various symptoms such as motor paralysis, gait disturbance, sensory abnormalities, and cognitive impairment. In particular, despite receiving intensive rehabilitation treatment, 55-75% of post-stroke patients remain impaired in upper extremity function, which reduces the quality of life. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive treatment that has the effect of adjusting cortical excitability according to frequency. This literature review was conducted to provide a more diverse clinical basis for applying rTMS to stroke patients in the future for recovery of upper extremity function. The databases of PubMed and Embase were searched using combinations of the following terms: stroke AND upper extremity AND transcranial magnetic stimulation. 10 randomized controlled trials (RCTs) that met the inclusion criteria were included in this literature review and extracted data included sample size, sample characteristics, study design, rTMS protocol, and outcome measurement. All included studies applied rTMS to M1 (primary motor cortex). 10 studies included in this literature review reported that HF-rTMS (High-frequency rTMS) or iTBS (intermittent theta-burst stimulation) to the ipsilateral M1 and LF-rTMS (Low-frequency rTMS) to the contralateral M1 resulted in significant improvements in upper extremity assessments, so this literature review suggests that rTMS is beneficial for the recovery of upper extremity function in stroke patients.