Navigated repetitive transcranial magnetic stimulation in post-stroke rehabilitation: a randomized, double-blind, sham-controlled study

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.