Overview
The hand weakness following a stroke stems from brain neurons destroyed by the stroke, as well as from surviving neurons. The surviving neurons become dormant (not active) through inactivity and suppression from the non-stroke hemisphere. In some patients, rTMS can help dormant neurons reactivate and thereby improve voluntary hand function.
Our approach
Unlike deep brain stimulation, rTMS is noninvasive and does not involve surgery. The patient receives painless magnetic pulses to the head through a device held by the clinician. Patients perform hand exercises while the effects of the magnetic stimulation are active.
Although the magnetic energy can be used to produce involuntary muscle contractions, rTMS uses repeated, low-intensity magnetic pulses to change brain synapses (pathways) so that people can more easily produce muscle contractions on their own. To help the effects of rTMS to last longer, it is important for people to use their weak hand in challenging tasks immediately after the treatment.
Our hand therapy uses a computer program that allows patients to move their hand to guide the virtual hand on the screen to make the same move. A variety of tasks can be created, like picking petals from a flower or stacking blocks. To make the effects permanent, people are urged to use their stroke hand diligently in all daily activities.
