Sharma H¹, Kumar N², Sreenivas V³, Rajeswari MR⁴ and Srivastava M V Padma ¹*

¹Department of Neurology, All-India Institutes of Medical Sciences, New Delhi, India
²Department of Psychiatry, All-India Institutes of Medical Sciences, New Delhi, India
³Department of Biostatistics, All-India Institutes of Medical Sciences, New Delhi, India
⁴Department of Biochemistry, All-India Institutes of Medical Sciences, New Delhi, India

*Corresponding Author:Srivastava M V Padma, Department of Neurology, All-India Institutes of Medical Sciences, New Delhi, India.

Received: June 30, 2022; Published: September 20, 2022

Abstract

Background: The therapeutic benefits and efficacy of repetitive trans cranial magnetic stimulation along with physical therapy in exerting the cellular and molecular aspects, and changes in neurophysiological markers during the functional recovery in ischemic stroke patients have not been fully elucidated. The aim of this study is to determine the role of serum growth factors levels as a surrogate marker, using 1Hz rTMS with conventional physiotherapy in patients with ischemic stroke.

Methods: Study participants with first ever ischemic stroke (N = 96), onset within 15 days were randomized after a run-in period of 75 ± 7 days along with standard physical therapy to receive 10 sessions of real 1Hz rTMS (N = 47) on contra lesion premotor cortex or to sham stimulation (N = 49) for 2 weeks. Participants, investigators and outcome assessors were blinded. The study outcomes were to measure changes in the expression levels of peripheral serum growth factors VEGF and BDNF and neurophysiological changes at third month.

Results: Modified intention to treat analysis showed significant up regulation in the mean levels of serum VEGF (797.24 ± 224.27) and BDNF (30.64 ± 9.64), P < 0.001 in Real rTMS Group. Trend of decrease in Resting Motor Threshold and an increase in Motor Evoked Potential in the affected hand was observed. Statistically significant negative correlation between motor evoked potential and mean VEGF (rho = -1.000, P < 0.001) in the affected hand in Real rTMS Group was seen.

Conclusion: Total ten sessions of 1Hz rTMS plus physical therapy on contralateral hemisphere resulted in up regulation of serum growth factors possible reflecting improved neuroplasticity.

Keywords: Ischemic Stroke; Transcranial Magnetic Stimulation; Serum Growth Factors; Motor Threshold; Motor Evoked Potential

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Citation

Citation: Srivastava Padma., et al. “Role of rTMS and Expression Levels of Serum Growth Factors Along with Neurophysiological Markers in Ischemic Stroke Recovery: A Double Blind, Parallel Group, Sham Controlled Randomized Study”. Acta Scientific Neurology 5.10 (2022): 33-47.

Copyright

Copyright: © 2022 Srivastava Padma., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.