The application of transcranial magnetic stimulation in the patients presenting with ischemic stroke in the acute, and early reconvalescence periods for diagnostic, therapeutic, and rehabilitative purposes (guidelines)

It is recommended to use functional transcranial magnetic stimulation for the estimation of the rehabilitative potential of the patients presenting with ischemic stroke and locomotor disorders in the acute, and early reconvalescence periods of the disease. The retention of motor evoked potentials from the affected hemisphere in the acute and early reconvalescence periods gives evidence of good prospects for the normalization of locomotor functions in the affected extremities. In contrast, the absence of motor evoked potentials from the affected hemisphere suggests the poor rehabilitative potential for the restoration of the locomotor functions. The patients who had undergone the newly diagnosed hemispheric ischemic stroke and thereafter developed locomotor disorders in combination with neurologic deficit exhibited changes in the motor evoked potentials not only from the affected hemisphere but also from the “intact” one. It means that the rehabilitative treatment should be extended onto the conventionally “intact” hemisphere. The authors proposed the method for the synchronous application of transcranial magnetic stimulation and electrical stimulation in the patients presenting with primary ischemic stroke and locomotor disorders provided that they retain the rehabilitative potential. This method makes it possible to improve the results of medical rehabilitation during the acute and early reconvalescence periods. In order to obtain the optimal outcome of rehabilitative measures, it is recommended to carry out magnetic stimulation of the affected and unaffected hemispheres at the frequencies of magnetic pulses 5 Hz and 1 Hz respectively simultaneously with electrical stimulation by the conventional method.

transcranial magnetic stimulation, ischemic stroke, locomotor disorders, rehabilitative potential