Deep rTMS on medial cortex for acute stroke patients

• Project/Area Number: 26350589
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: International University of Health and Welfare
• Principal Investigator: Sasaki Nobuyuki 国際医療福祉大学, 大学病院, 教授 (60328325)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Project Status: Completed (Fiscal Year 2016)
• Budget Amount: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000); Fiscal Year 2016: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000); Fiscal Year 2015: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000); Fiscal Year 2014: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 経頭蓋磁気刺激 / 脳卒中 / リハビリテーション / 下肢麻痺 / 自発性 / 高次脳機能障害 / 片麻痺 / アパシー / 急性期 / 非侵襲的脳刺激

Outline of Final Research Achievements

No study has examined the usefulness of repetitive transcranial magnetic stimulation (rTMS) for lower limb hemiparesis and post stroke apathy in patients with acute stroke. 21 acute stroke patients were randomly assigned into two groups: the high frequency (HF)-rTMS group and the sham stimulation group. Patients received rTMS for 5 consecutive days. The improvement in paretic leg motor function was significant in the HF-rTMS group.
13 chronic stroke patients were assigned randomly to two groups: rTMS group and sham stimulation group. The patients received 5 sessions of either HF-rTMS over the region spanning from the dorsal anterior cingulate cortex (dACC) to medial prefrontal cortex (mPFC) or sham stimulation for 5 days. The severity of apathy was significantly improved in the rTMS group. This rTMS application was also safe and feasible for recovery of apathy in acute phase.
Application of rTMS has potential to be a new rehabilitation therapy for patients in the acute phase of stroke.

Research Products

• [Journal Article] The efficacy of high-frequency repetitive transcranial magnetic stimulation for improving apathy in chronic stroke patients (2017)
  • Author(s): Sasaki N, Hara T, Yamada N, Niimi M, Kakuda W, Abo M
  • Journal Title: European Neurology Volume: 印刷中 Issue: 1-2 Pages: 28-32
  • DOI: 10.1159/000477440
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] High-frequency rTMS on leg motor area in the early phase of stroke. (2017)
  • Author(s): Sasaki N, Abo M, Hara T, Yamada N, Niimi M, Kakuda W
  • Journal Title: Acta Neurol Belg Volume: 117 Issue: 1 Pages: 189-194
  • DOI: 10.1007/s13760-016-0687-1
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] 脳卒中麻痺治療の最前線～急性期脳卒中上肢麻痺・下肢麻痺に対する反復性経頭蓋磁気刺激（rTMS） (2015)
  • Author(s): 佐々木信幸
  • Journal Title: 医工学治療 Volume: 27 Pages: 108-112
• [Journal Article] 急性期症例へのTMS． (2015)
  • Author(s): 佐々木信幸
  • Journal Title: Modern Physician Volume: 35 Pages: 1501-1505
• [Journal Article] Bilateral high- and low-frequency rTMS in acute stroke patients with hemiparesis: A comparative study with unilateral high-frequency rTMS. (2014)
  • Author(s): Nobuyuki Sasaki
  • Journal Title: Brain Injury Volume: 28 Issue: 13-14 Pages: 1682-1686
  • DOI: 10.3109/02699052.2014.947626
  • Peer Reviewed
• [Journal Article] Repetitive Transcranial Magnetic Stimulation for Hemiparesis before Pacemaker Implantation in a Case with Cerebral Embolism due to a Left Atrial Myxoma (2014)
  • Author(s): 佐々木信幸
  • Journal Title: The Japanese Journal of Rehabilitation Medicine Volume: 51 Issue: 6 Pages: 378-382
  • DOI: 10.2490/jjrmc.51.378
  • NAID: 130004678794
  • ISSN: 1881-3526, 1881-8560
  • Peer Reviewed
• [Presentation] 回復期脳卒中患者の内側前頭前皮質及び背側帯状回への高頻度rTMS(ケースシリーズ) (2016)
  • Author(s): 佐々木信幸，安保雅博
  • Organizer: 第53回日本リハビリテーション医学会学術集会
  • Place of Presentation: 京都
  • Year and Date: 2016-06-09
• [Presentation] 慢性期脳卒中患者の内側前頭前皮質及び背側前帯状回への高頻度rTMS (2016)
  • Author(s): 佐々木信幸，安保雅博
  • Organizer: 第41回日本脳卒中学会総会
  • Place of Presentation: 札幌
  • Year and Date: 2016-04-14
• [Presentation] High-frequency rTMS on leg motor area for acute stroke patients. (2015)
  • Author(s): Nobuyuki Sasaki
  • Organizer: The 1st Asia-Oceanian Congress for NeuroRehabilitation
  • Place of Presentation: Seoul
  • Year and Date: 2015-09-04
  • Int'l Joint Research
• [Presentation] Clinical Practice of Therapeutic rTMS for Post-Stroke Patients~Our proposed protocol and its clinical results. (2015)
  • Author(s): Nobuyuki Sasaki
  • Organizer: The 1st Asia-Oceanian Congress for NeuroRehabilitation
  • Place of Presentation: Seoul
  • Year and Date: 2015-09-03
  • Int'l Joint Research
• [Presentation] 急性期重症者にこそ重要なリハビリテーション介入 (2015)
  • Author(s): 佐々木信幸
  • Organizer: 第19回エンドトキシン血症救命治療研究会
  • Place of Presentation: 江陽グランドホテル
  • Year and Date: 2015-01-23
  • Invited
• [Presentation] 回復期リハビリテーションに必要な評価 (2014)
  • Author(s): 佐々木信幸
  • Organizer: 第2回医師のための総合リハビリテーション講座
  • Place of Presentation: ベルサール九段
  • Year and Date: 2014-08-30
  • Invited
• [Presentation] 発症早期の脳卒中患者の下肢麻痺に対する高頻度rTMSの効果. (2014)
  • Author(s): 佐々木信幸
  • Organizer: 第51回日本リハビリテーション医学会学術集会
  • Place of Presentation: 名古屋国際会議場
  • Year and Date: 2014-06-06
• [Book] 治療を支える疾患別リハビリテーション栄養． (2016)
  • Author(s): 佐々木信幸
  • Total Pages: 313
  • Publisher: 南江堂
• [Book] 最新リハビリテーション医学 (2016)
  • Author(s): 佐々木信幸
  • Total Pages: 456
  • Publisher: 医歯薬出版