Cortical Hemispheric Responses to 5 Hz Repetitive Transcranial Magnetic Stimulation in Chronic Stroke: An EEG-Based Study

This study investigated the effects of 5 Hz repetitive transcranial magnetic stimulation (rTMS) on cortical activation and upper limb function in patients with chronic stroke. Twenty-four patients received 5 Hz rTMS three times per week for four weeks. Electroencephalography (EEG) was used to analyze sensorimotor rhythm (SMR) and the hemispheric asymmetry index (HAI), and upper limb function was assessed using the Fugl- Meyer Assessment (FMA) and the Box and Block Test (BBT). SMR significantly increased in the ipsilesional central regions (C3, C4), while HAI significantly decreased after the intervention (p < 0.05), indicating restoration of interhemispheric balance. In addition, FMA and BBT scores showed significant improvement and were positively correlated with EEG indices. These findings suggest that 5 Hz rTMS promotes cortical reorganization and contributes to upper limb motor recovery in patients with chronic stroke.