{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:25:54Z","timestamp":1792787154481,"version":"4.5.0"},"reference-count":0,"publisher":"SPIE-Intl Soc Optical Eng","issue":"S1","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Key R&D Program of China","award":["2022YFC3602704"],"award-info":[{"award-number":["2022YFC3602704"]}]},{"name":"National Natural Science Foundation of China","award":["82472590"],"award-info":[{"award-number":["82472590"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Program of Rehabilitation Institute, Shanghai Jiao Tong University School of Medicine","award":["yskf2-23-1107-1"],"award-info":[{"award-number":["yskf2-23-1107-1"]}],"id":[{"id":"https:\/\/ror.org\/0220qvk04","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurophoton."],"published-print":{"date-parts":[[2026,2,10]]},"abstract":"<jats:p>SignificanceInterhemispheric imbalance after stroke impedes motor recovery. Although repetitive transcranial magnetic stimulation (rTMS) shows therapeutic potential, the neural mechanisms underlying its effects\u2014particularly on cortical excitability and interhemispheric interaction\u2014remain unclear. Understanding these mechanisms is essential for optimizing personalized neuromodulation strategies in stroke rehabilitation.AimTo explore how low-frequency rTMS facilitates motor recovery post-stroke, especially in regulating interhemispheric inhibition (IHI), functional connectivity, and cortical excitability, we used a multimodal approach that included paired-pulse TMS, functional near-infrared spectroscopy (fNIRS), and motor outcomes.ApproachA total of 27 patients with stroke were randomized to receive 2 weeks of either real (n=14) or sham (n=13) 1\u00a0Hz rTMS over the contralesional primary motor cortex (M1). Paired-pulse TMS was used to measure IHI and laterality quotient (LQ), whereas fNIRS was used to measure resting-state functional connectivity (RSFC). Clinical scales were also used to assess behavioral-level motor functioning.ResultsCompared with the sham group, rTMS significantly modulated IHI, as evidenced by a reduction in inhibitory drive from the stimulated contralesional M1 to ipsilesional M1 (mean difference = 15.57%, p=0.048). In parallel, RSFC analysis revealed decreased connectivity from contralesional M1 to ipsilesional premotor and supplementary motor areas [F(2,50)=7.704, p=0.006, false discovery rate\u2013corrected]. Between-group comparisons further showed greater LQ improvements in the rTMS group than in the sham group. Changes in selected neurophysiological measures were significantly correlated with improvements in upper limb motor function.ConclusionsWe showed that low-frequency rTMS promotes motor recovery after stroke by rebalancing cortical excitability and reducing maladaptive connectivity patterns. The integration of TMS and fNIRS provides converging evidence for rTMS-induced cortical plasticity and highlights the potential of these tools for guiding personalized neuromodulation strategies in stroke rehabilitation.<\/jats:p>","DOI":"10.1117\/1.nph.13.s1.s13010","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:29:25Z","timestamp":1770748165000},"page":"1-19","source":"Crossref","is-referenced-by-count":2,"title":["Investigating repetitive transcranial magnetic stimulation\u2013induced interhemispheric changes in stroke: a transcranial magnetic stimulation and fNIRS study"],"prefix":"10.1117","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3570-9554","authenticated-orcid":false,"given":"Siqi","family":"Yang","sequence":"first","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaomei","family":"Li","sequence":"additional","affiliation":[{"name":"Ruijin Rehabilitation Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fen","family":"Zhang","sequence":"additional","affiliation":[{"name":"KU Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert","family":"Verheyden","sequence":"additional","affiliation":[{"name":"KU Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Chen","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongfang","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawen","family":"Yang","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanxin M.","family":"Niu","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jixian","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Xie","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"189","container-title":["Neurophotonics"],"original-title":[],"link":[{"URL":"https:\/\/www.spiedigitallibrary.org\/journals\/neurophotonics\/volume-13\/issue-S1\/S13010\/Investigating-repetitive-transcranial-magnetic-stimulationinduced-interhemispheric-changes-in-stroke\/10.1117\/1.NPh.13.S1.S13010.full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:21:00Z","timestamp":1790194860000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.spiedigitallibrary.org\/journals\/neurophotonics\/volume-13\/issue-S1\/S13010\/Investigating-repetitive-transcranial-magnetic-stimulationinduced-interhemispheric-changes-in-stroke\/10.1117\/1.NPh.13.S1.S13010.full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":0,"journal-issue":{"issue":"S1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1117\/1.nph.13.s1.s13010","relation":{},"ISSN":["2329-423X","2329-4248"],"issn-type":[{"value":"2329-423X","type":"print"},{"value":"2329-4248","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]}}}