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Here, we compared the effects of RPSS\n                      <jats:sub>SUPRA<\/jats:sub>\n                      and RPSS delivered at subsensory intensity (RPSS\n                      <jats:sub>SUB<\/jats:sub>\n                      ) on motor function and levels of \u03b3-aminobutyric acid (GABA)+ (GABA plus coedited macromolecules) measured by proton magnetic resonance spectroscopy in the ipsilesional and contralesional primary motor cortex at different stages post-stroke.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this multicenter, randomized proof-of-principle clinical trial, 51 participants in the early subacute or chronic phases after stroke were assigned to receive a single session of either RPSS\n                      <jats:sub>SUPRA<\/jats:sub>\n                      or RPSS\n                      <jats:sub>SUB<\/jats:sub>\n                      of the median nerve, followed by motor training. Jebsen\u2013Taylor test (JTT) scores were assessed before RPSS, after RPSS, and after training. GABA+ ipsilesional\/contralesional ratios (GABA+\n                      <jats:sub>ipsilesional\/contralesional<\/jats:sub>\n                      ) were calculated. The data were analyzed with generalized estimation equations with the factors INTERVENTION, GROUP, and TIME.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The percent change in JTT performance was significantly affected by TIME, with greater improvements after training than after RPSS across groups. For absolute JTT scores, there was a significant INTERVENTION\u2009\u00d7\u2009GROUP\u2009\u00d7\u2009TIME interaction. In the subacute phase, JTT performance declined significantly post-RPSS\n                      <jats:sub>SUPRA<\/jats:sub>\n                      and improved significantly post-RPSS\n                      <jats:sub>SUB<\/jats:sub>\n                      , whereas in the chronic phase, performance improved significantly following both RPSS\n                      <jats:sub>SUB<\/jats:sub>\n                      and RPSS\n                      <jats:sub>SUPRA<\/jats:sub>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001 for all Bonferroni comparisons). GABA+\n                      <jats:sub>ipsilesional\/contralesional ratios<\/jats:sub>\n                      decreased significantly after RPSS\n                      <jats:sub>SUPRA<\/jats:sub>\n                      in the subacute phase (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.008) and remained unchanged in the other groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subsensory and suprasensory RPSS have distinct effects on motor performance and M1 GABA+ levels in well-recovered individuals in the subacute and chronic phases post-stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration:<\/jats:title>\n                    <jats:p>NCT03956407 (2019\/05\/20).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15459683261426351","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T17:36:08Z","timestamp":1774892168000},"page":"523-536","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Divergent Effects of Repetitive Peripheral Stimulation in Subacute and Chronic Stroke: Results From the RESTORES Proof-of-Principle Randomized Trial"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7869-3490","authenticated-orcid":false,"given":"Adriana B.","family":"Conforto","sequence":"first","affiliation":[{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, SP, Brazil"},{"name":"LIM-44, Magnetic Resonance in Neuroradiology Laboratory, Hospital das Cl\u00ednicas, University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymundo M. de Azevedo","family":"Neto","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamim","family":"Handfas","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Zaiden","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isadora O.","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Rafael\/D\u2019Or Institute for Research and Education (IDOR), Salvador, BA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiago","family":"Gava","sequence":"additional","affiliation":[{"name":"School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathlein","family":"Pouza","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzana B.","family":"Reis","sequence":"additional","affiliation":[{"name":"School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisele S.","family":"Silva","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Edson","family":"Amaro","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzete N. 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