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. 2020 Mar 23;10(3):186.
doi: 10.3390/brainsci10030186.

Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) Combined With Aerobic Exercise on the Recovery of Motor Function in Ischemic Stroke Rat Model

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Free PMC article

Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) Combined With Aerobic Exercise on the Recovery of Motor Function in Ischemic Stroke Rat Model

Juanxiu Cui et al. Brain Sci. .
Free PMC article

Abstract

The therapeutic benefits of repetitive transcranial magnetic stimulation (rTMS) combined with rehabilitation therapy on recovery after stroke have not been fully elucidated. This study aimed to explore the therapeutic effects of rTMS followed by aerobic exercise on neuroplasticity and recovery of motor function in a rat model of permanent middle cerebral artery occlusion (MCAO). Rats were randomized into sham operation (N = 10, sham op), MCAO (N = 10, control group), rTMS (N = 10, MCAO and rTMS therapy), and combination groups (N = 10, MCAO and combination therapy). High-frequency rTMS (10 Hz) was applied on the ipsilesional forepaw motor cortex, and aerobic exercise training on the rotarod was performed for two weeks. The rotarod and Garcia tests were conducted to evaluate changes in behavioral function. Motor evoked potentials (MEPs) were used to evaluate electrophysiological changes. Stroke severity was assessed using infarction volume measurement. Neuronal recovery was explored with western blot for brain-derived neurotrophic factor (BDNF) pathway proteins. Compared with control therapy, combination therapy was significantly more effective than rTMS therapy for improving function on the rotarod test (p = 0.08), Garcia test (p = 0.001), and MEP amplitude (p = 0.001) In conclusion, combination therapy may be a potential treatment to promote recovery of motor function and neuroplasticity in stroke patients.

Keywords: exercise; function recovery; middle cerebral artery occlusion; neuroplasticity; transcranial magnetic stimulation.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Timeline of the intervention experiment and evaluation.
Figure 2
Figure 2
Stimulation protocol of repetitive transcranial magnetic stimulation; RMT: resting motor threshold.
Figure 3
Figure 3
The latency to fall (A) and distance to fall (B) of the rotarod test showed a significant decrease from three days to 14 days in the permanent middle cerebral artery occlusion rat model compared with pre-operation. The combination group had a significant difference with rTMS and control groups (p < 0.05). Values are mean ± SEM. * p < 0.17 versus combination group. # p < 0.17 versus the rTMS group.
Figure 4
Figure 4
The total score for the Garcia test (% of pre) are shown. The significant decrease from three days to 14 days in the permanent middle cerebral artery occlusion rat model compared with pre-operation. The data showed that there was a significant difference among the three group (p < 0.05).Values are mean ± SEM. * p < 0.017 versus combination group. # p < 0.017 versus the rTMS group.
Figure 5
Figure 5
Motor evoked potentials amplitude change between 3 and 15 days. A significant difference was seen in the combination group compared with the control group (* p < 0.017). Values are mean ± SEM. * p < 0.17 versus combination group.
Figure 6
Figure 6
Triphenyltetrazolium chloride (TTC) stain for rat brain at 15 days (A), the infarction area of the three group did not show significant difference (B). Values are mean ± SEM.
Figure 7
Figure 7
The proteins of BDNF (A), p-TrkB (B), p-AKT (C) in the BDNF-TrkB signaling pathways were higher in the combination group compared with the control group. * p < 0.017. Values are mean ± SEM.

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