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Neurology and Therapy

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Open Access 01-03-2022 | Stroke | Original Research

Functional Near-Infrared Spectroscopy as a Target Navigator for rTMS Modulation in Patients with Hemiplegia: A Randomized Control Study

Authors: Pang-Wei Chang, Chia-Feng Lu, Shin-Tsu Chang, Po-Yi Tsai

Published in: Neurology and Therapy | Issue 1/2022

Abstract

Introduction

Although repetitive transcranial magnetic stimulation (rTMS) is efficacious for motor neuromodulation in stroke survivors, high interindividual variability for responsiveness remains a concern. Target probing on the skull using a proper brain-mapping technique may help overcome this challenge. This study assessed the feasibility of functional near-infrared spectroscopy (fNIRS) as a target navigator in rTMS treatment for motor facilitation in patients with stroke.

Methods

Fifty-one patients with stroke were enrolled in this randomized controlled study. The patients were assigned to three groups: fNIRS-guided rTMS treatment (fNIRS group, n = 20), motor evoked potential (MEP)-guided rTMS treatment (MEP group, n = 16), and sham (n = 15) group. Motor assessments, including Fugl–Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), and muscle strength, were conducted at baseline and after the 10-session rTMS treatment.

Results

The fNIRS-guided hotspot (fNIRS-HS) was obtained for each patient, even those for whom the MEP-guided hotspot was undetectable. Both intervention groups exhibited significant improvements in muscle strength, FMA, and WMFT scores (P < 0.001) compared with the sham group. The fNIRS group achieved significantly greater improvement in elbow function (P = 0.001) than the MEP group.

Conclusion

fNIRS can be a reliable tool for hotspot navigation for motor neuromodulation in patients with stroke. With high sensitivity to cortical oxygenation changes, this navigation system achieved a superior outcome to the traditional MEP-based method in patients with stroke. fNIRS-based systems may also facilitate the integration of machine learning, thus enabling precision medicine for neuromodulation.

Trial Registration

https://clinicaltrials.gov; Unique identifier: NCT02006615.

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Title: Functional Near-Infrared Spectroscopy as a Target Navigator for rTMS Modulation in Patients with Hemiplegia: A Randomized Control Study
Authors: Pang-Wei Chang
Chia-Feng Lu
Shin-Tsu Chang
Po-Yi Tsai
Publication date: 01-03-2022
Publisher: Springer Healthcare
Keywords: Stroke
Motor Evoked Potential
Repetitive Transcranial Magnetic Stimulation
Motor Evoked Potential
Hemiplegia
Published in: Neurology and Therapy / Issue 1/2022
Print ISSN: 2193-8253
Electronic ISSN: 2193-6536
DOI: https://doi.org/10.1007/s40120-021-00300-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Functional Near-Infrared Spectroscopy as a Target Navigator for rTMS Modulation in Patients with Hemiplegia: A Randomized Control Study

Abstract

Introduction

Methods

Results

Conclusion

Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Trial Registration

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