Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector8310.17816/psaic83Original articlesОригинальные статьиUnknownNavigated repetitive transcranial magnetic stimulation in post-stroke rehabilitation: a randomized, double-blind, sham-controlled studyНавигационная ритмическая транскраниальная магнитная стимуляция в постинсультной реабилитации: рандомизированное слепое плацебо-контролируемое исследованиеChervyakovA. V.ЧервяковA. В.
Russian Federation
nasu2709@mail.ruhttps://orcid.org/0000-0003-1841-1177PoydashevaAlexandra G.ПойдашеваАлександра Георгиевна
Russian Federation

junior researcher, neurologist, Department of neurorehabilitation and physiotherapy

м.н.с., врач-невролог отд. нейрореабилитации и физиотерапии

nasu2709@mail.ruNazarovaM. А.НазароваM. А.
Russian Federation
nasu2709@mail.ruGnezditskyV. V.ГнездицкийВ. В.
Russian Federation
nasu2709@mail.ruhttps://orcid.org/0000-0003-3956-6362SuponevaNatalya A.СупоневаНаталья Александровна
Russian Federation

D. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, principal researcher, Department of neurorehabilitation and physiotherapy

д.м.н., проф., член-корреспондент РАН, г.н.с. отд. нейрореабилитации и физиотерапии

nasu2709@mail.ruChernikovaL. A.ЧерниковаЛ. A.
Russian Federation
nasu2709@mail.ruhttps://orcid.org/0000-0002-6338-0392PiradovMikhail A.ПирадовМихаил Александрович
Russian Federation

D. Sci. (Med.), Professor, Full Member of the Russian Academy of Sciences, Director

д.м.н., проф., академик РАН, директор

nasu2709@mail.ruResearch Center of NeurologyФГБНУ «Научный центр неврологии»0712201594303631012017Copyright ©; 2015, Chervyakov A.V., Poydasheva A.G., Nazarova M.А., Gnezditsky V.V., Suponeva N.A., Chernikova L.A., Piradov M.A.Copyright ©; 2015, Chervyakov A.V., Poydasheva A.G., Nazarova M.А., Gnezditsky V.V., Suponeva N.A., Chernikova L.A., Piradov M.A.2015Chervyakov A.V., Poydasheva A.G., Nazarova M.А., Gnezditsky V.V., Suponeva N.A., Chernikova L.A., Piradov M.A.Chervyakov A.V., Poydasheva A.G., Nazarova M.А., Gnezditsky V.V., Suponeva N.A., Chernikova L.A., Piradov M.A.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/83

Navigated rTMS is characterized by a great accuracy of localizing the stimulated area, which opens up new prospects for neuroplasticity modulation. We conducted an interventional randomized double-blind sham-controlled study to evaluate the effectiveness of navigated rTMS in post-stroke rehabilitation. We found that low-frequency stimulation reliably reduces severity of motor deficit and increases the Barthel Index of Activities of Daily Living. High-frequency stimulation reduces spasticity (Ashworth Scale) and severity of central post-stroke pain syndrome. Navigated repetitive transcranial magnetic stimulation effectively supplements the conventional rehabilitation of poststroke patients. Compared to routine TMS, the use of navigated rTMS enables effective control of the neuroplastic processes and provides new opportunities in development of personalized neurorehabilitation programs.

Навигационная рТМС обладает значительно большей точностью в локализации зоны стимуляции, что открывает большие перспективы для модуляции нейропластичности. Проведено интервенционное рандомизированное двойное слепое плацебо-контролируемое исследование для оценки эффективности навигационной рТМС в постинсультной реабилитации. Установлено, что низкочастотная стимуляция достоверно снижает выраженность моторного дефицита и повышает индекс повседневной жизненной активности Бартел. Высокочастотная стимуляция достоверно уменьшает спастичность по шкале Ашворта и выраженность центрального постинсультного болевого синдрома. Полученные данные обосновывают использование рТМС в комплексе реабилитации пациентов после инсульта. Применение навигационной рТМС, по сравнению с рутинной ТМС (без навигации), позволяет более эффективно воздействовать на нейропластические процессы и открывает новые возможности в персонализированном подборе нейрореабилитационных программ.

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