{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:00:37Z","timestamp":1789419637226,"version":"build-2803163510"},"reference-count":37,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19H01091"],"award-info":[{"award-number":["19H01091"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["22H04788"],"award-info":[{"award-number":["22H04788"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23H00459"],"award-info":[{"award-number":["23H00459"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cell.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Heliyon"],"published-print":{"date-parts":[[2023,4]]},"DOI":"10.1016\/j.heliyon.2023.e15564","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T12:42:50Z","timestamp":1681821770000},"page":"e15564","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"title":["Low-frequency repetitive transcranial magnetic stimulation can alleviate spasticity and induce functional recovery in patients with severe chronic stroke: A prospective, non-controlled, pilot study"],"prefix":"10.1016","volume":"9","author":[{"given":"Yoshihiro","family":"Yukawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6719-758X","authenticated-orcid":false,"given":"Sumiya","family":"Shibata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-6517","authenticated-orcid":false,"given":"Satoko","family":"Koganemaru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Minakuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Shimomura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9682-364X","authenticated-orcid":false,"given":"Kazuhito","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7787-4855","authenticated-orcid":false,"given":"Tatsuya","family":"Mima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.heliyon.2023.e15564_bib1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1056\/NEJMoa1804355","article-title":"MRI-guided thrombolysis for stroke with unknown time of onset","volume":"379","author":"Thomalla","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.heliyon.2023.e15564_bib2","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","article-title":"Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials","volume":"387","author":"Goyal","year":"2016","journal-title":"Lancet"},{"key":"10.1016\/j.heliyon.2023.e15564_bib3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s42466-020-00060-6","article-title":"Recovery from stroke: current concepts and future perspectives","volume":"2","author":"Grefkes","year":"2020","journal-title":"Neurol. Res. Pract."},{"key":"10.1016\/j.heliyon.2023.e15564_bib4","doi-asserted-by":"crossref","first-page":"e98","DOI":"10.1161\/STR.0000000000000098","article-title":"Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"47","author":"Winstein","year":"2016","journal-title":"Stroke"},{"key":"10.1016\/j.heliyon.2023.e15564_bib5","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/j.clinph.2019.11.002","article-title":"Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): an update (2014\u20132018)","volume":"131","author":"Lefaucheur","year":"2020","journal-title":"Clin. Neurophysiol."},{"key":"10.1016\/j.heliyon.2023.e15564_bib6","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1113\/jphysiol.1992.sp019243","article-title":"Interhemispheric inhibition of the human motor cortex","volume":"453","author":"Ferbert","year":"1992","journal-title":"J. Physiol."},{"key":"10.1016\/j.heliyon.2023.e15564_bib7","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.brs.2017.01.006","article-title":"Targeting interhemispheric inhibition with neuromodulation to enhance stroke rehabilitation","volume":"10","author":"Boddington","year":"2017","journal-title":"Brain Stimul."},{"key":"10.1016\/j.heliyon.2023.e15564_bib8","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1002\/ana.10848","article-title":"Influence of interhemispheric interactions on motor function in chronic stroke","volume":"55","author":"Murase","year":"2004","journal-title":"Ann. Neurol."},{"key":"10.1016\/j.heliyon.2023.e15564_bib9","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1212\/01.WNL.0000161839.38079.92","article-title":"A sham stimulation-controlled trial of rTMS of the unaffected hemisphere in stroke patients","volume":"64","author":"Mansur","year":"2005","journal-title":"Neurology"},{"key":"10.1016\/j.heliyon.2023.e15564_bib10","doi-asserted-by":"crossref","first-page":"2681","DOI":"10.1161\/01.STR.0000189658.51972.34","article-title":"Repetitive transcranial magnetic stimulation of contralesional primary motor cortex improves hand function after stroke","volume":"36","author":"Takeuchi","year":"2005","journal-title":"Stroke"},{"key":"10.1016\/j.heliyon.2023.e15564_bib11","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1161\/01.STR.0000231390.58967.6b","article-title":"A sham-controlled trial of a 5-day course of repetitive transcranial magnetic stimulation of the unaffected hemisphere in stroke patients","volume":"37","author":"Fregni","year":"2006","journal-title":"Stroke"},{"key":"10.1016\/j.heliyon.2023.e15564_bib12","doi-asserted-by":"crossref","first-page":"496","DOI":"10.3109\/02699052.2011.559610","article-title":"Anti-spastic effect of low-frequency rTMS applied with occupational therapy in post-stroke patients with upper limb hemiparesis","volume":"25","author":"Kakuda","year":"2011","journal-title":"Brain Inj."},{"key":"10.1016\/j.heliyon.2023.e15564_bib13","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1743-0003-9-4","article-title":"A multi-center study on low-frequency rTMS combined with intensive occupational therapy for upper limb hemiparesis in post-stroke patients","volume":"9","author":"Kakuda","year":"2012","journal-title":"J. NeuroEng. Rehabil."},{"key":"10.1016\/j.heliyon.2023.e15564_bib14","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1111\/ijs.12056","article-title":"Functional cortical reorganization after low-frequency repetitive transcranial magnetic stimulation plus intensive occupational therapy for upper limb hemiparesis: evaluation by functional magnetic resonance imaging in poststroke patients","volume":"8","author":"Yamada","year":"2013","journal-title":"Int. J. Stroke"},{"key":"10.1016\/j.heliyon.2023.e15564_bib15","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000026339","article-title":"Does a combination treatment of repetitive transcranial magnetic stimulation and occupational therapy improve upper limb muscle paralysis equally in patients with chronic stroke caused by cerebral hemorrhage and infarction?: a retrospective Cohort study","volume":"100","author":"Tatsuno","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.heliyon.2023.e15564_bib16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"10.1016\/j.heliyon.2023.e15564_bib17","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1016\/j.clinph.2009.08.016","article-title":"Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research","volume":"120","author":"Rossi","year":"2009","journal-title":"Clin. Neurophysiol."},{"key":"10.1016\/j.heliyon.2023.e15564_bib18","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.clinph.2012.01.010","article-title":"A practical guide to diagnostic transcranial magnetic stimulation: report of an IFCN committee","volume":"123","author":"Groppa","year":"2012","journal-title":"Clin. Neurophysiol."},{"key":"10.1016\/j.heliyon.2023.e15564_bib19","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1177\/154596802401105171","article-title":"The Fugl-Meyer assessment of motor recovery after stroke: a critical review of its measurement properties","volume":"16","author":"Gladstone","year":"2002","journal-title":"Neurorehabil. Neural Repair"},{"key":"10.1016\/j.heliyon.2023.e15564_bib20","first-page":"158","article-title":"Efficacy of vibration-induced illusory movement tasks on upper-extremity motor dysfunction in stroke survivors","volume":"40","author":"Yukawa","year":"2021","journal-title":"Jpn. Occup. Therapy Res."},{"key":"10.1016\/j.heliyon.2023.e15564_bib21","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/MRR.0b013e3282ab961d","article-title":"A new evaluation method for upper extremity dexterity of patients with hemiparesis after stroke: the 10-second tests","volume":"30","author":"Hatanaka","year":"2007","journal-title":"Int. J. Rehabil. Res."},{"key":"10.1016\/j.heliyon.2023.e15564_bib22","first-page":"347","article-title":"Technique to improve chronic motor deficit after stroke","volume":"74","author":"Taub","year":"1993","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"10.1016\/j.heliyon.2023.e15564_bib23","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/ptj\/67.2.206","article-title":"Interrater reliability of a modified Ashworth scale of muscle spasticity","volume":"67","author":"Rw","year":"1987","journal-title":"Phys. Ther."},{"key":"10.1016\/j.heliyon.2023.e15564_bib24","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.1161\/STROKEAHA.117.020607","article-title":"Randomized sham-controlled trial of navigated repetitive transcranial magnetic stimulation for motor recovery in stroke: the NICHE trial","volume":"49","author":"Harvey","year":"2018","journal-title":"Stroke"},{"key":"10.1016\/j.heliyon.2023.e15564_bib25","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1038\/35018000","article-title":"Transcranial magnetic stimulation and the human brain","volume":"406","author":"Hallett","year":"2000","journal-title":"Nature"},{"key":"10.1016\/j.heliyon.2023.e15564_bib26","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.neuroimage.2009.12.029","article-title":"Modulating cortical connectivity in stroke patients by rTMS assessed with fMRI and dynamic causal modeling","volume":"50","author":"Grefkes","year":"2010","journal-title":"Neuroimage"},{"key":"10.1016\/j.heliyon.2023.e15564_bib27","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1097\/01.wnr.0000177010.44602.5e","article-title":"Transcranial direct current stimulation of the unaffected hemisphere in stroke patients","volume":"16","author":"Fregni","year":"2005","journal-title":"Neuroreport"},{"key":"10.1016\/j.heliyon.2023.e15564_bib28","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1161\/STROKEAHA.109.577023","article-title":"Lesion load of the corticospinal tract predicts motor impairment in chronic stroke","volume":"41","author":"Zhu","year":"2010","journal-title":"Stroke"},{"key":"10.1016\/j.heliyon.2023.e15564_bib29","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1002\/ana.24472","article-title":"Proportional recovery after stroke depends on corticomotor integrity","volume":"78","author":"Byblow","year":"2015","journal-title":"Ann. Neurol."},{"key":"10.1016\/j.heliyon.2023.e15564_bib30","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1093\/brain\/awl333","article-title":"Functional potential in chronic stroke patients depends on corticospinal tract integrity","volume":"130","author":"Stinear","year":"2007","journal-title":"Brain"},{"key":"10.1016\/j.heliyon.2023.e15564_bib31","series-title":"Symposium Synopsis. Spasticity: Disordered Motor Control","first-page":"485","author":"Lance","year":"1980"},{"key":"10.1016\/j.heliyon.2023.e15564_bib32","first-page":"S12","article-title":"Spasticity: a review","volume":"44","author":"Young","year":"1994","journal-title":"Neurology"},{"key":"10.1016\/j.heliyon.2023.e15564_bib33","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1046\/j.1468-1331.2002.0090s1003.x","article-title":"The pathophysiology of spasticity","volume":"9","author":"Sheean","year":"2002","journal-title":"Eur. J. Neurol."},{"key":"10.1016\/j.heliyon.2023.e15564_bib34","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1136\/jnnp.57.7.773","article-title":"Pathophysiology of spasticity","volume":"57","author":"Brown","year":"1994","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"10.1016\/j.heliyon.2023.e15564_bib35","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3389\/fneur.2017.00120","article-title":"Spasticity, motor recovery, and neural plasticity after stroke","volume":"8","author":"Li","year":"2017","journal-title":"Front. Neurol."},{"key":"10.1016\/j.heliyon.2023.e15564_bib36","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1002\/(SICI)1097-4598(1997)6+<21::AID-MUS4>3.0.CO;2-L","article-title":"Common patterns of clinical motor dysfunction","volume":"20","author":"Mayer","year":"1997","journal-title":"Muscle Nerve: Offi. J. Am. Assoc. Electrodiagn. Med."},{"key":"10.1016\/j.heliyon.2023.e15564_bib37","doi-asserted-by":"crossref","first-page":"154","DOI":"10.3389\/fnsys.2015.00154","article-title":"Two is more than one: how to combine brain stimulation rehabilitative training for functional recovery?","volume":"9","author":"Koganemaru","year":"2015","journal-title":"Front. Syst. Neurosci."}],"container-title":["Heliyon"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405844023027718?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405844023027718?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:46:19Z","timestamp":1778597179000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2405844023027718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["S2405844023027718"],"URL":"https:\/\/doi.org\/10.1016\/j.heliyon.2023.e15564","relation":{},"ISSN":["2405-8440"],"issn-type":[{"value":"2405-8440","type":"print"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Low-frequency repetitive transcranial magnetic stimulation can alleviate spasticity and induce functional recovery in patients with severe chronic stroke: A prospective, non-controlled, pilot study","name":"articletitle","label":"Article Title"},{"value":"Heliyon","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.heliyon.2023.e15564","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"e15564"}}