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Brain Stimulation May Improve Hemispatial Neglect in Stroke

Theta-burst stimulation of intact left posterior parietal cortex for two weeks improves neglect

WEDNESDAY, Dec. 14 (HealthDay News) -- In patients with subacute right hemispheric (RH) ischemic stroke, continuous theta-burst stimulation (cTBS) of intact posterior parietal cortex (PPC) of the left hemisphere (LH) improves hemispatial neglect after two weeks of treatment, according to a study published online Dec. 14 in Neurology.

Giacomo Koch, M.D., Ph.D., from the Santa Lucia Foundation IRCCS in Rome, and colleagues investigated the safety and efficacy of cTBS in patients with subacute RH ischemic stroke in 10 sessions over two weeks. Twenty consecutive patients were randomly allocated to real and sham LH PPC cTBS. A standardized Behavioral Inattention Test (BIT) was used to assess the severity of hemispatial neglect. The effect of cTBS on the excitability of the parieto-frontal functional connections in the intact LH were measured by bifocal transcranial magnetic stimulation.

The investigators found that the neglect symptoms improved after two weeks of real, but not sham, cTBS. In the real cTBS group, the BIT score improved by 16.3 and 22.6 percent after two weeks and at one month of follow-up, respectively. Real, but not sham cTBS, reduced the hyperexcitability of LH parieto-frontal circuits.

"These findings suggest that a two-week course of cTBS over the LH PPC may be a potential effective strategy in accelerating recovery from visuospatial neglect in subacute stroke patients, possibly counteracting the hyperexcitability of LH parieto-frontal circuits," the authors write.

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