Malaysian Journal of Medical Sciences
School of Medical Sciences, Universiti Sains Malaysia
Vol. 25, No. 2, 2018, pp. 116-125
Bioline Code: mj18027
Full paper language: English
Document type: Research Article
Document available free of charge
Malaysian Journal of Medical Sciences, Vol. 25, No. 2, 2018, pp. 116-125
© Copyright 2018 - Penerbit Universiti Sains Malaysia
Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients|
Hanafi, Muhammad Hafiz; Kassim, Nur Karyatee; Ibrahim, Al Hafiz; Mohd Adnan, Munirah; Ahmad, Wan Muhamad Amir W; Idris, Zamzuri & Abdul Latif, Lydia
Background: Stroke is one of the leading causes of mortality and morbidity in Malaysia.
Repetitive transcranial magnetic stimulation (rTMS) is one of the new non-invasive modality to
enhance the motor recovery in stroke patients.
Objectives: This pilot study compared the motor evoked potential (MEP) changes using
different settings of rTMS in the post-ischemic stroke patient. The goal of the study is to identify
effect sizes for a further trial and evaluate safety aspects.
Methods: Eight post-stroke patients with upper limb hemiparesis for at least six months
duration were studied in a tertiary hospital in Northeast Malaysia. Quasi experimental design was
applied and the participants were randomised into two groups using software generated random
numbers. One of the two settings: i) inhibitory setting, or ii) facilitatory setting have been applied
randomly during the first meeting. The motor evoked potential (MEP) were recorded before and
after application of the rTMS setting. A week later, a similar procedure will be repeated but using
different setting than the first intervention. Each patient will serve as their own control. Repeated
measures ANOVA test was applied to determine the effect sizes for both intervention through the
options of partial eta-squared (η2p).
Result: The study observed large effect sizes (η2p > 0.14) for both rTMS settings in the
lesion and non-lesion sides. For safety aspects, no minor or major side effects associated with the
rTMS was reported by the participants.
Conclusions: The partial eta square of MEP value for both rTMS settings (fascilitatory
and inhibitory) in both lesion and non-lesion sides represents large effect sizes. We recommend
further trial to increase number of sample in order to study the effectiveness of both settings in
ischemic stroke patient. Our preliminary data showed both settings may improve the MEP of the
upper extremity in the ischemic stroke patient. No significant improvement noted when comparing
stroke; motor evoked potential; repetitive transcranial magnetic stimulation
Alternative site location: http://www.medic.usm.my/publication/mjms/