Local Muscle Injection of Botulinum Toxin Type A Synergistically Improves the Beneficial Effects of Repetitive Transcranial Magnetic Stimulation and Intensive Occupational Therapy in Post-Stroke Patients with Spastic Upper Limb Hemiparesis

2014 ◽  
Vol 72 (5-6) ◽  
pp. 290-298 ◽  
Author(s):  
Naoki Yamada ◽  
Wataru Kakuda ◽  
Takahiro Kondo ◽  
Sugao Mitani ◽  
Masato Shimizu ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Transcranial Magnetic Stimulation ◽  
Upper Limb ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Stroke Patients ◽  
Beneficial Effects ◽  
Upper Limb Hemiparesis

Role of d-serine in the beneficial effects of repetitive transcranial magnetic stimulation in post-stroke patients

2020 ◽  
Vol 32 (3) ◽  
pp. 128-134 ◽  
Author(s):  
Masachika Niimi ◽  
Yuko Fujita ◽  
Tamaki Ishima ◽  
Kenji Hashimoto ◽  
Nobuyuki Sasaki ◽  
...  
Keyword(s):  
Amino Acids ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Beneficial Effects ◽  
Depressed Patients ◽  
Before And After ◽  
The Impact

AbstractObjective:Abnormalities in neurotransmission via N-methyl-d-aspartic acid receptor (NMDAR) play a role in the pathophysiology of neuropsychiatric disorders. The impact of repetitive transcranial magnetic stimulation (rTMS) on NMDAR-related amino acids remains unknown. We aim to investigate the effects of rTMS on NMDAR-related amino acids in serum of post-stroke patients.Methods:Ninety-five consecutive post-stroke patients with upper limb hemiparesis were recruited. In 27 patients, the Beck Depression Inventory (BDI) score was 10 or higher. Twelve depressed patients underwent rehabilitation in combination with rTMS and 15 non-depressed patients underwent rehabilitation only without rTMS for 14 days. 1 Hz rTMS was applied to the primary motor area in the non-lesional hemisphere. BDI was conducted before and after treatment. Serum glutamine, glutamate, glycine, l-serine, and d-serine levels were measured before and after treatment.Results:There were no differences between depressed patients and non-depressed patients in clinical characteristics, levels of the five amino acids in serum, and the ratio of amino acids. However, in 27 depressed patients, there was a significant correlation between levels of glutamate in serum and BDI (ρ = 0.428, p = 0.026). BDI decreased significantly in depressed patients after treatment with or without rTMS. d-serine decreased in the rehabilitation with rTMS group, but increased in the rehabilitation without rTMS group. l-serine increased in the rehabilitation with rTMS group, but decreased in the rehabilitation without rTMS group.Conclusion:The results suggest that rTMS can modulate NMDAR-related amino acids in blood, producing beneficial effects.

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