A study by a group out of the University of Cologne in Germany has demonstrated that rTMS over the unaffected motor cortex of patients that have had a stroke will make their use of the affected hand more efficient and quicker.
The paper explains how rTMS is thought to work in a very nice manner and backs it up with a diagram that puts it into very understandable terms. Essentially there is imbalance between the two sides of the brain after a stroke. There are excitatory and inhibitory inputs from both sides of the brain which help us fine tune our movements, making them efficient, accurate and adaptable. Add a prehensile thumb and you start to understand the magnitude of the human brain. Now that we are figuring out how to rebalance a damaged brain the possibilities are becoming apparent. And I am sure that when we look back in twenty years or more at the preliminary data and concepts we will laugh at our shallow understanding of the subject.
Once again, I am amazed by the clinical implications of this. As a physiatrist (Physical Medicine and Rehabilitation specialist that works with stroke patients) I am encouraged and excited by the possibilities that are starting to present themselves. This is a technology that is going to revolutionize stroke rehabilitation; I am unsure if there are other advances that have occurred in this field that are comparable. The advent of clot busting drugs was a milestone, the development and use of advanced imaging techniques as well. Neuromodulation as a therapeutic intervention and as a research tool has staggering possibilities.
