The Effect of Low-Frequency (1 Hz) rTMS on the Cerebellar Cortex in Patients with Ataxia After a Posterior Circulation Stroke : Randomized Control Trial

To assess the Safety, feasibility, and efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) applied to the cerebellum in patients with acute posterior circulation stroke. Thirty ataxic patients with acute posterior circulation stroke were randomized to experimental (EG = 15) and control groups (CG = 15). All subjects received a 30-minute mirror therapy in common, which consisted of lower limb strengthening exercises and balance enhancement program related to functional tasks. During this intervention, mirrors were placed on the front and side walls to provide visual feedback about their movement. EG applied 1HZ real rTMS for 15 minutes to the cerebellum before mirror treatment and sham rTMS for CG. Intervention was performed once a day, five times a week for four weeks. Static balance test, Wisconsin gait scale, 6 minute walk test (6MWT) and time up go test (TUG) were performed before and after the intervention. At post-test, Static balance test (98.53.68 ± 6.94 versus 110.53 ± 16.83), Wisconsin gait scale (25.61 ± 4.86 versus 29.54 ± 5.82), 6 minute walk test (181.47 ± 34.52 versus 165.72 ± 35.63), time up go test (24.47 ± 4.55 versus 28.93 ± 3.13) was a significant difference in the experimental group than in the control group (p < 0.05). There was a significant difference between the pre-test and post-test scores for all variables in both groups (p < 0.01). The results of this study show that 1 Hz rTMS application to the cerebellum is safe and feasible and may have beneficial effects on the balance function of stroke patients with posterior circulation dysfunction.