Modulating motor function after stroke: Differential effects of high-frequency rTMS on movement kinematics and neural activity in subcortical and cortical MCA stroke

Objective: Following the concept of interhemispheric competition, up-regulating the cortical excitability of the ipsilesional motor cortex (M1) may improve dexterity of the affected hand after stroke. We here examined the effects of 10Hz rTMS over ipsilesional M1 on both movement kinematics and neural activity assessed with 3 Tesla fMRI after (i) subcortical and (ii) cortical stroke. Methods: 15 subjects with impaired dexterity due to subcortical middle cerebral artery (MCA) stroke and 13 subjects with cortical MCA stroke received 10Hz rTMS (5s stimulation, 25s break, 1000 pulses, 80% of the resting motor thresh…