{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:04:47Z","timestamp":1790701487247,"version":"4.1.0"},"reference-count":80,"publisher":"IMR Press","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["82302865"],"award-info":[{"award-number":["82302865"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Natural Science Foundation of China","award":["82172544"],"award-info":[{"award-number":["82172544"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Youth Fund of Shanghai Municipal Health Commission","award":["20214Y0508"],"award-info":[{"award-number":["20214Y0508"]}]},{"name":"Shanghai Science and Technology Committee Sailing Program","award":["23YF1403800"],"award-info":[{"award-number":["23YF1403800"]}]},{"name":"Shanghai Zhou Liangfu Medical Development Foundation \u201cBrain Science and Brain Diseases Youth Innovation Program\u201d"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Integr. Neurosci."],"abstract":"<jats:p>Background: Repetitive transcranial magnetic stimulation (rTMS) has demonstrated efficacy as a neuromodulatory technique in subacute and chronic stroke phases. However, evidence regarding its effectiveness in the acute phase remains limited, necessitating further synthesis and evaluation. Methods: A comprehensive search was conducted across PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL (EBSCOhost) to November 1, 2025. The intervention in the experimental group must involve rTMS with or without any additional rehabilitation. Using a random-effects model, standardized mean differences (Hedges\u2019 g) were calculated for motor function (Fugl-Meyer Assessment, FMA), neurological deficits (National Institutes of Health Stroke Scale, NIHSS), independence (Barthel Index, BI), disability (Modified Rankin Scale, mRS), grip strength, and neurophysiological parameters (Motor Evoked Potential (MEP) amplitude, resting motor threshold (RMT), Central Motor Conduction Time (CMCT)). Heterogeneity was assessed using the I2 statistic, and analyses were conducted with Stata. Results: A systematic literature search identified 17 studies meeting the inclusion criteria involving 846 acute ischemic stroke adults. rTMS significantly improved motor recovery (FMA: p &lt; 0.01) and reduced neurological deficits (NIHSS: p &lt; 0.01). It also enhanced independence (BI: p = 0.01) and reduced disability (mRS: p &lt; 0.01; grip strength: p = 0.01). Neurophysiological outcomes indicated increased corticospinal excitability in the lesioned hemisphere (MEP amplitude: p &lt; 0.01) and reduced RMT (p &lt; 0.01), with no significant effect on CMCT. Subgroup analyses showed comparable benefits between ipsilesional high-frequency and contralesional low-frequency rTMS, though high-frequency protocols yielded significant improvements in activities of daily living (p = 0.01). Subthreshold stimulation and threshold stimulation were associated with NIHSS improvements (p &lt; 0.01). Suprathreshold stimulation showed a non\u2011significant effect (p = 0.11). Conclusions: Despite heterogeneity and limitations in evidence quality, rTMS shows promise as a neurorehabilitative intervention in acute stroke, potentially by modulating interhemispheric balance and promoting neuroplasticity.<\/jats:p>","DOI":"10.31083\/jin49076","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:16:31Z","timestamp":1790698591000},"source":"Crossref","is-referenced-by-count":0,"title":["Unlocking Early Neural Plasticity: A Systematic Review and Meta-Analysis of Repetitive Transcranial Magnetic Stimulation on Motor Recovery in Acute Stroke"],"prefix":"10.31083","volume":"25","author":[{"given":"Meixi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"National Center for Neurological Disorders, Huashan Hospital, Fudan University, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haozheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"National Center for Neurological Disorders, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"School of Exercise and Health, Shanghai University of Sport, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoman","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuqin","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Shanghai Xinqidian Rehabilitation Hospital, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shucong","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"School of Exercise and Health, Shanghai University of Sport, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junqiu","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, General Hospital of Ningxia Medical University, 750000 Yinchuan, Ningxia, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5943-6708","authenticated-orcid":true,"given":"Xiangtong","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"National Center for Neurological Disorders, Huashan Hospital, Fudan University, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4955-3533","authenticated-orcid":true,"given":"Yi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"National Center for Neurological Disorders, Huashan Hospital, Fudan University, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7670-0773","authenticated-orcid":true,"given":"Lu","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200000 Shanghai, China"},{"name":"National Center for Neurological Disorders, Huashan Hospital, Fudan University, 200000 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"GBD 2019 Australia Collaborators. The burden and trend of diseases and their risk factors in Australia, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. Public Health. 2023; 8: e585\u2013e599.","DOI":"10.1016\/S2468-2667(23)00123-8"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Grefkes C, Fink GR. Recovery from stroke: current concepts and future perspectives. Neurological Research and Practice. 2020; 2: 17.","DOI":"10.1186\/s42466-020-00060-6"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"O'Brien AT, Bertolucci F, Torrealba-Acosta G, Huerta R, Fregni F, Thibaut A. Non-invasive brain stimulation for fine motor improvement after stroke: a meta-analysis. European Journal of Neurology. 2018; 25: 1017\u20131026.","DOI":"10.1111\/ene.13643"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Keser Z, Ikramuddin S, Shekhar S, Feng W. Neuromodulation for Post-Stroke Motor Recovery: a Narrative Review of Invasive and Non\u2011Invasive Tools. Current Neurology and Neuroscience Reports. 2023; 23: 893\u2013906.","DOI":"10.1007\/s11910-023-01319-6"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Dion\u00edsio A, Duarte IC, Patr\u00edcio M, Castelo-Branco M. The Use of Repetitive Transcranial Magnetic Stimulation for Stroke Rehabilitation: A Systematic Review. Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association. 2018; 27: 1\u201331.","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.09.008"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Li H, Guan C, Fang D, Yang Y, Hsieh M, et al. Research hotspots and global trends in transcranial magnetic stimulation for stroke neurorestoration: A 30-year bibliometric analysis. Journal of Neurorestoratology. 2025; 13: 100148.","DOI":"10.1016\/j.jnrt.2024.100148"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Di Lazzaro V, Pilato F, Dileone M, Profice P, Capone F, Ranieri F, et al. Modulating cortical excitability in acute stroke: a repetitive TMS study. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2008; 119: 715\u2013723.","DOI":"10.1016\/j.clinph.2007.11.049"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"McDonnell MN, Stinear CM. TMS measures of motor cortex function after stroke: A meta-analysis. Brain Stimulation. 2017; 10: 721\u2013734.","DOI":"10.1016\/j.brs.2017.03.008"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Kubis N. Non-Invasive Brain Stimulation to Enhance Post-Stroke Recovery. Frontiers in Neural Circuits. 2016; 10: 56.","DOI":"10.3389\/fncir.2016.00056"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Carey JR, Chappuis DM, Finkelstein MJ, Frost KL, Leuty LK, McNulty AL, et al. Importance and Difficulties of Pursuing rTMS Research in Acute Stroke. Physical Therapy. 2017; 97: 310\u2013319.","DOI":"10.1093\/ptj\/pzx005"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Stinear C, Ackerley S, Byblow W. Rehabilitation is initiated early after stroke, but most motor rehabilitation trials are not: a systematic review. Stroke. 2013; 44: 2039\u20132045.","DOI":"10.1161\/STROKEAHA.113.000968"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Ahmed I, Mustafaoglu R, Benkhalifa N, Yakhoub YH. Does noninvasive brain stimulation combined with other therapies improve upper extremity motor impairment, functional performance, and participation in activities of daily living after stroke? A systematic review and meta-analysis of randomized controlled trial. Topics in Stroke Rehabilitation. 2023; 30: 213\u2013234.","DOI":"10.1080\/10749357.2022.2026278"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Chen Q, Shen D, Sun H, Ke J, Wang H, Pan S, et al. Effects of coupling inhibitory and facilitatory repetitive transcranial magnetic stimulation on motor recovery in patients following acute cerebral infarction. NeuroRehabilitation. 2021; 48: 83\u201396.","DOI":"10.3233\/NRE-201606"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Guan YZ, Li J, Zhang XW, Wu S, Du H, Cui LY, et al. Effectiveness of repetitive transcranial magnetic stimulation (rTMS) after acute stroke: A one-year longitudinal randomized trial. CNS Neuroscience & Therapeutics. 2017; 23: 940\u2013946.","DOI":"10.1111\/cns.12762"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Du J, Tian L, Liu W, Hu J, Xu G, Ma M, et al. Effects of repetitive transcranial magnetic stimulation on motor recovery and motor cortex excitability in patients with stroke: a randomized controlled trial. European Journal of Neurology. 2016; 23: 1666\u20131672.","DOI":"10.1111\/ene.13105"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Du J, Yang F, Liu L, Hu J, Cai B, Liu W, et al. Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagia: A randomized, double-blind clinical trial. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2016; 127: 1907\u20131913.","DOI":"10.1016\/j.clinph.2015.11.045"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Du J, Yang F, Hu J, Hu J, Xu Q, Cong N, et al. Effects of high- and low-frequency repetitive transcranial magnetic stimulation on motor recovery in early stroke patients: Evidence from a randomized controlled trial with clinical, neurophysiological and functional imaging assessments. NeuroImage. Clinical. 2019; 21: 101620.","DOI":"10.1016\/j.nicl.2018.101620"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Juan Du, Yao W, Li J, Yang F, Hu J, Xu Q, et al. Motor Network Reorganization After Repetitive Transcranial Magnetic Stimulation in Early Stroke Patients: A Resting State fMRI Study. Neurorehabilitation and Neural Repair. 2022; 36: 61\u201368.","DOI":"10.1177\/15459683211054184"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Matsuura A, Onoda K, Oguro H, Yamaguchi S. Magnetic stimulation and movement-related cortical activity for acute stroke with hemiparesis. European Journal of Neurology. 2015; 22: 1526\u20131532.","DOI":"10.1111\/ene.12776"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Watanabe K, Kudo Y, Sugawara E, Nakamizo T, Amari K, Takahashi K, et al. Comparative study of ipsilesional and contralesional repetitive transcranial magnetic stimulations for acute infarction. Journal of the Neurological Sciences. 2018; 384: 10\u201314.","DOI":"10.1016\/j.jns.2017.11.001"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Khedr EM, Ahmed MA, Fathy N, Rothwell JC. Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke. Neurology. 2005; 65: 466\u2013468.","DOI":"10.1212\/01.wnl.0000173067.84247.36"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Khedr EM, Abo-Elfetoh N, Rothwell JC. Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation. Acta Neurologica Scandinavica. 2009; 119: 155\u2013161.","DOI":"10.1111\/j.1600-0404.2008.01093.x"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Khedr EM, Etraby AE, Hemeda M, Nasef AM, Razek AAE. Long-term effect of repetitive transcranial magnetic stimulation on motor function recovery after acute ischemic stroke. Acta Neurologica Scandinavica. 2010; 121: 30\u201337.","DOI":"10.1111\/j.1600-0404.2009.01195.x"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Komatsu T, Hada T, Sasaki N, Kida H, Maku T, Nakada R, et al. Effects and safety of high-frequency rTMS in subacute ischemic stroke patients. Journal of the Neurological Sciences. 2024; 462: 123069.","DOI":"10.1016\/j.jns.2024.123069"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Zhu Z, Zhu HX, Jing SW, Li XZ, Yang XY, Luo TN, et al. Effect of transcranial magnetic stimulation in combination with citalopram on patients with post-stroke depression. Frontiers in Human Neuroscience. 2022; 16: 962231.","DOI":"10.3389\/fnhum.2022.962231"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Liepert J, Zittel S, Weiller C. Improvement of dexterity by single session low-frequency repetitive transcranial magnetic stimulation over the contralesional motor cortex in acute stroke: a double-blind placebo-controlled crossover trial. Restorative Neurology and Neuroscience. 2007; 25: 461\u2013465.","DOI":"10.3233\/RNN-2007-00401"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Guo Z, Jin Y, Bai X, Jiang B, He L, McClure MA, et al. Distinction of High- and Low-Frequency Repetitive Transcranial Magnetic Stimulation on the Functional Reorganization of the Motor Network in Stroke Patients. Neural Plasticity. 2021; 2021: 8873221.","DOI":"10.1155\/2021\/8873221"},{"key":"ref28","unstructured":"Valovi\u010dov\u00e1 K, Koll\u00e1r B, Klobuck\u00e1 S, Goldenberg Z, \u0160va\u0148ov\u00e1 S, Stre\u010dansk\u00e1 A, et al. Effects of high-frequency repetitive transcranial magnetic stimulation of affected hemisphere on motor recovery in patients in the acute stage of ischemic stroke: Preliminary results. Neuro Endocrinology Letters. 2024; 45: 409\u2013417."},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Ma J, Qian S, Ma N, Zhang L, Xu L, Liu X, et al. Effect of short-term 10 Hz repeated transcranial magnetic stimulation on postural control ability in patients with mild hemiparesis in acute ischemic stroke: a single-blinded randomized controlled trial. Frontiers in Neurology. 2024; 15: 1439904.","DOI":"10.3389\/fneur.2024.1439904"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Lefaucheur JP, Aleman A, Baeken C, Benninger DH, Brunelin J, Di Lazzaro V, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018). Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2020; 131: 474\u2013528.","DOI":"10.1016\/j.clinph.2019.11.002"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Fan S, Yan L, Zhang J, Qian Y, Wang M, Yang L, et al. Effects of repetitive transcranial magnetic stimulation on lower extremity motor function and optimal parameters in stroke patients with different stages of stroke: a systematic evaluation and meta-analysis. Frontiers in Neurology. 2024; 15: 1372159.","DOI":"10.3389\/fneur.2024.1372159"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"Hofmeijer J, Ham F, Kwakkel G. Evidence of rTMS for Motor or Cognitive Stroke Recovery: Hype or Hope? Stroke. 2023; 54: 2500\u20132511.","DOI":"10.1161\/STROKEAHA.123.043159"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Zhang JJY, Ang J, Saffari SE, Tor PC, Lo YL, Wan KR. Repetitive Transcranial Magnetic Stimulation for Motor Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials With Low Risk of Bias. Neuromodulation : Journal of the International Neuromodulation Society. 2025; 28: 16\u201342.","DOI":"10.1016\/j.neurom.2024.07.010"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"Paolucci S, Antonucci G, Grasso MG, Morelli D, Troisi E, Coiro P, et al. Early versus delayed inpatient stroke rehabilitation: a matched comparison conducted in Italy. Archives of Physical Medicine and Rehabilitation. 2000; 81: 695\u2013700.","DOI":"10.1016\/s0003-9993(00)90095-9"},{"key":"ref35","unstructured":"Novack TA, Satterfield WT, Lyons K, Kolski G, Hackmeyer L, Connor M. Stroke onset and rehabilitation: time lag as a factor in treatment outcome. Archives of Physical Medicine and Rehabilitation. 1984; 65: 316\u2013319."},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"Joy MT, Carmichael ST. Encouraging an excitable brain state: mechanisms of brain repair in stroke. Nature Reviews. Neuroscience. 2021; 22: 38\u201353.","DOI":"10.1038\/s41583-020-00396-7"},{"key":"ref37","unstructured":"Liu Y, Yin JH, Lee JT, Peng GS, Yang FC. Early Rehabilitation after Acute Stroke:The Golden Recovery Period. Acta Neurologica Taiwanica. 2023; 32: 1\u20138."},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"Cifu DX, Stewart DG. Factors affecting functional outcome after stroke: a critical review of rehabilitation interventions. Archives of Physical Medicine and Rehabilitation. 1999; 80: S35\u2013S39.","DOI":"10.1016\/s0003-9993(99)90101-6"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restorative Neurology and Neuroscience. 2004; 22: 281\u2013299.","DOI":"10.3233\/RNN-2004-00282"},{"key":"ref40","doi-asserted-by":"publisher","unstructured":"Gao F, Wang S, Guo Y, Wang J, Lou M, Wu J, et al. Protective effects of repetitive transcranial magnetic stimulation in a rat model of transient cerebral ischaemia: a microPET study. European Journal of Nuclear Medicine and Molecular Imaging. 2010; 37: 954\u2013961.","DOI":"10.1007\/s00259-009-1342-3"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"Guo F, Lou J, Han X, Deng Y, Huang X. Repetitive Transcranial Magnetic Stimulation Ameliorates Cognitive Impairment by Enhancing Neurogenesis and Suppressing Apoptosis in the Hippocampus in Rats with Ischemic Stroke. Frontiers in Physiology. 2017; 8: 559.","DOI":"10.3389\/fphys.2017.00559"},{"key":"ref42","doi-asserted-by":"publisher","unstructured":"Hong Y, Liu Q, Peng M, Bai M, Li J, Sun R, et al. High-frequency repetitive transcranial magnetic stimulation improves functional recovery by inhibiting neurotoxic polarization of astrocytes in ischemic rats. Journal of Neuroinflammation. 2020; 17: 150.","DOI":"10.1186\/s12974-020-01747-y"},{"key":"ref43","doi-asserted-by":"publisher","unstructured":"Fujiki M, Kobayashi H, Abe T, Kamida T. Repetitive transcranial magnetic stimulation for protection against delayed neuronal death induced by transient ischemia. Journal of Neurosurgery. 2003; 99: 1063\u20131069.","DOI":"10.3171\/jns.2003.99.6.1063"},{"key":"ref44","doi-asserted-by":"publisher","unstructured":"Luo L, Liu M, Fan Y, Zhang J, Liu L, Li Y, et al. Intermittent theta-burst stimulation improves motor function by inhibiting neuronal pyroptosis and regulating microglial polarization via TLR4\/NF\u03baB\/NLRP3 signaling pathway in cerebral ischemic mice. Journal of Neuroinflammation. 2022; 19: 141.","DOI":"10.1186\/s12974-022-02501-2"},{"key":"ref45","doi-asserted-by":"publisher","unstructured":"Yoon KJ, Lee YT, Han TR. Mechanism of functional recovery after repetitive transcranial magnetic stimulation (rTMS) in the subacute cerebral ischemic rat model: neural plasticity or anti-apoptosis? Experimental Brain Research. 2011; 214: 549\u2013556.","DOI":"10.1007\/s00221-011-2853-2"},{"key":"ref46","doi-asserted-by":"publisher","unstructured":"Li M, Peng J, Song Y, Liang H, Mei Y, Fang Y. Electro-acupuncture combined with transcranial magnetic stimulation improves learning and memory function of rats with cerebral infarction by inhibiting neuron cell apoptosis. Journal of Huazhong University of Science and Technology. Medical Sciences = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying De Wen Ban = Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban. 2012; 32: 746\u2013749.","DOI":"10.1007\/s11596-012-1028-0"},{"key":"ref47","doi-asserted-by":"publisher","unstructured":"Luo J, Zheng H, Zhang L, Zhang Q, Li L, Pei Z, et al. High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Improves Functional Recovery by Enhancing Neurogenesis and Activating BDNF\/TrkB Signaling in Ischemic Rats. International Journal of Molecular Sciences. 2017; 18: 455.","DOI":"10.3390\/ijms18020455"},{"key":"ref48","doi-asserted-by":"publisher","unstructured":"Roque C, Pinto N, Vaz Patto M, Baltazar G. Astrocytes contribute to the neuronal recovery promoted by high-frequency repetitive magnetic stimulation in in vitro models of ischemia. Journal of Neuroscience Research. 2021; 99: 1414\u20131432.","DOI":"10.1002\/jnr.24792"},{"key":"ref49","doi-asserted-by":"publisher","unstructured":"Bai G, Jiang L, Huan S, Meng P, Wang Y, Pan X, et al. Study on Low-Frequency Repetitive Transcranial Magnetic Stimulation Improves Speech Function and Mechanism in Patients With Non-fluent Aphasia After Stroke. Frontiers in Aging Neuroscience. 2022; 14: 883542.","DOI":"10.3389\/fnagi.2022.883542"},{"key":"ref50","doi-asserted-by":"publisher","unstructured":"Bai G, Jiang L, Ma W, Meng P, Li J, Wang Y, et al. Effect of Low-Frequency rTMS and Intensive Speech Therapy Treatment on Patients With Nonfluent Aphasia After Stroke. The Neurologist. 2020; 26: 6\u20139.","DOI":"10.1097\/NRL.0000000000000303"},{"key":"ref51","doi-asserted-by":"publisher","unstructured":"Xiang H, Sun J, Tang X, Zeng K, Wu X. The effect and optimal parameters of repetitive transcranial magnetic stimulation on motor recovery in stroke patients: a systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation. 2019; 33: 847\u2013864.","DOI":"10.1177\/0269215519829897"},{"key":"ref52","doi-asserted-by":"publisher","unstructured":"Khedr EM, Fetoh NAE. Short- and long-term effect of rTMS on motor function recovery after ischemic stroke. Restorative Neurology and Neuroscience. 2010; 28: 545\u2013559.","DOI":"10.3233\/RNN-2010-0558"},{"key":"ref53","doi-asserted-by":"publisher","unstructured":"Murphy TH, Corbett D. Plasticity during stroke recovery: from synapse to behaviour. Nature Reviews. Neuroscience. 2009; 10: 861\u2013872.","DOI":"10.1038\/nrn2735"},{"key":"ref54","doi-asserted-by":"publisher","unstructured":"Xu H, Qin W, Chen H, Jiang L, Li K, Yu C. Contribution of the resting-state functional connectivity of the contralesional primary sensorimotor cortex to motor recovery after subcortical stroke. PLoS One. 2014; 9: e84729.","DOI":"10.1371\/journal.pone.0084729"},{"key":"ref55","doi-asserted-by":"publisher","unstructured":"Ward NS, Brown MM, Thompson AJ, Frackowiak RSJ. Neural correlates of outcome after stroke: a cross-sectional fMRI study. Brain : a Journal of Neurology. 2003; 126: 1430\u20131448.","DOI":"10.1093\/brain\/awg145"},{"key":"ref56","doi-asserted-by":"publisher","unstructured":"Liu L, Ding M, Wu J, Zhang Y, Wang Q, Wang N, et al. High-frequency repetitive transcranial magnetic stimulation promotes ipsilesional functional hyperemia and motor recovery in mice with ischemic stroke. Cerebral Cortex (New York, N.Y. : 1991). 2024; 34: bhae074.","DOI":"10.1093\/cercor\/bhae074"},{"key":"ref57","doi-asserted-by":"publisher","unstructured":"Rossi S, Antal A, Bestmann S, Bikson M, Brewer C, Brockm\u00f6ller J, et al. Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2021; 132: 269\u2013306.","DOI":"10.1016\/j.clinph.2020.10.003"},{"key":"ref58","doi-asserted-by":"publisher","unstructured":"Huang YZ, Rothwell JC. The effect of short-duration bursts of high-frequency, low-intensity transcranial magnetic stimulation on the human motor cortex. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2004; 115: 1069\u20131075.","DOI":"10.1016\/j.clinph.2003.12.026"},{"key":"ref59","doi-asserted-by":"publisher","unstructured":"Chung SW, Rogasch NC, Hoy KE, Sullivan CM, Cash RFH, Fitzgerald PB. Impact of different intensities of intermittent theta burst stimulation on the cortical properties during TMS-EEG and working memory performance. Human Brain Mapping. 2018; 39: 783\u2013802.","DOI":"10.1002\/hbm.23882"},{"key":"ref60","doi-asserted-by":"publisher","unstructured":"Turi Z, Lenz M, Paulus W, Mittner M, Vlachos A. Selecting stimulation intensity in repetitive transcranial magnetic stimulation studies: A systematic review between 1991 and 2020. The European Journal of Neuroscience. 2021; 53: 3404\u20133415.","DOI":"10.1111\/ejn.15195"},{"key":"ref61","doi-asserted-by":"publisher","unstructured":"Wang Y, Fang K, He S, Fan Y, Yu J, Zhang X. Effects of repetitive magnetic stimulation on the growth of primarily cultured hippocampus neurons in vitro and their expression of iron-containing enzymes. Neuropsychiatric Disease and Treatment. 2019; 15: 927\u2013934.","DOI":"10.2147\/NDT.S199328"},{"key":"ref62","doi-asserted-by":"publisher","unstructured":"Ma J, Zhang Z, Su Y, Kang L, Geng D, Wang Y, et al. Magnetic stimulation modulates structural synaptic plasticity and regulates BDNF-TrkB signal pathway in cultured hippocampal neurons. Neurochemistry International. 2013; 62: 84\u201391.","DOI":"10.1016\/j.neuint.2012.11.010"},{"key":"ref63","unstructured":"Balyts'ky\u012d OP. Using transcranial magnetic stimulation for studying functional state of motor centers in patients with ischemic stroke. Likars'ka Sprava. 2013; 75\u201380. (In Ukrainian)"},{"key":"ref64","doi-asserted-by":"publisher","unstructured":"Kiers L. Magnetic stimulation of the motor cortex: Clinical applications. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. 1997; 4: 3\u20138.","DOI":"10.1016\/s0967-5868(97)90002-3"},{"key":"ref65","doi-asserted-by":"publisher","unstructured":"Jo JY, Lee A, Kim MS, Park E, Chang WH, Shin YI, et al. Prediction of Motor Recovery Using Quantitative Parameters of Motor Evoked Potential in Patients With Stroke. Annals of Rehabilitation Medicine. 2016; 40: 806\u2013815.","DOI":"10.5535\/arm.2016.40.5.806"},{"key":"ref66","doi-asserted-by":"publisher","unstructured":"Rapisarda G, Bastings E, de Noordhout AM, Pennisi G, Delwaide PJ. Can motor recovery in stroke patients be predicted by early transcranial magnetic stimulation? Stroke. 1996; 27: 2191\u20132196.","DOI":"10.1161\/01.str.27.12.2191"},{"key":"ref67","unstructured":"Nascimbeni A, Gaffuri A, Imazio P. Motor evoked potentials: prognostic value in motor recovery after stroke. Functional Neurology. 2006; 21: 199\u2013203."},{"key":"ref68","doi-asserted-by":"publisher","unstructured":"Delvaux V, Alagona G, G\u00e9rard P, De Pasqua V, Pennisi G, de Noordhout AM. Post-stroke reorganization of hand motor area: a 1-year prospective follow-up with focal transcranial magnetic stimulation. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2003; 114: 1217\u20131225.","DOI":"10.1016\/s1388-2457(03)00070-1"},{"key":"ref69","doi-asserted-by":"publisher","unstructured":"Tamburini P, Mazzoli D, Stagni R. Towards an objective assessment of motor function in sub-acute stroke patients: Relationship between clinical rating scales and instrumental gait stability indexes. Gait & Posture. 2018; 59: 58\u201364.","DOI":"10.1016\/j.gaitpost.2017.09.033"},{"key":"ref70","doi-asserted-by":"publisher","unstructured":"Chong B, Wang A, Stinear CM. Proportional Recovery After Stroke: Addressing Concerns Regarding Mathematical Coupling and Ceiling Effects. Neurorehabilitation and Neural Repair. 2023; 37: 488\u2013498.","DOI":"10.1177\/15459683231177598"},{"key":"ref71","doi-asserted-by":"publisher","unstructured":"Gladstone DJ, Danells CJ, Black SE. The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabilitation and Neural Repair. 2002; 16: 232\u2013240.","DOI":"10.1177\/154596802401105171"},{"key":"ref72","doi-asserted-by":"publisher","unstructured":"Chen R. Guideline on therapeutic use of repetitive transcranial magnetic stimulation: Useful but know the methods and limitations. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2020; 131: 461\u2013462.","DOI":"10.1016\/j.clinph.2019.11.020"},{"key":"ref73","doi-asserted-by":"publisher","unstructured":"Button KS, Ioannidis JPA, Mokrysz C, Nosek BA, Flint J, Robinson ESJ, et al. Power failure: why small sample size undermines the reliability of neuroscience. Nature Reviews. Neuroscience. 2013; 14: 365\u2013376.","DOI":"10.1038\/nrn3475"},{"key":"ref74","doi-asserted-by":"publisher","unstructured":"Arboix A, Massons J, Garc\u00eda-Eroles L, Targa C, Comes E, Parra O, et al. Nineteen-year trends in risk factors, clinical characteristics and prognosis in lacunar infarcts. Neuroepidemiology. 2010; 35: 231\u2013236.","DOI":"10.1159\/000319460"},{"key":"ref75","doi-asserted-by":"publisher","unstructured":"Torres-Riera S, Arboix A, Parra O, Garc\u00eda-Eroles L, S\u00e1nchez-L\u00f3pez MJ. Predictive Clinical Factors of In-Hospital Mortality in Women Aged 85 Years or More with Acute Ischemic Stroke. Cerebrovascular Diseases (Basel, Switzerland). 2025; 54: 11\u201319.","DOI":"10.1159\/000536436"},{"key":"ref76","doi-asserted-by":"publisher","unstructured":"McCalley DM, Cadicamo NJ, Weijerman F, Tenekedjieva LT, Alzheimer\u2019s Disease Neuroimaging Initiative, Knutson B, et al. Females have shorter scalp-to-cortex distances and receive stronger TMS electrical fields: Implications for clinical treatment. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2026; 51: 722\u2013731.","DOI":"10.1038\/s41386-025-02299-6"},{"key":"ref77","doi-asserted-by":"publisher","unstructured":"Kuo YL, Lin G, Glatt SJ. The Impact of Brain-Derived Neurotrophic Factor Polymorphism and Stimulation Parameters on the Response to Repetitive Transcranial Magnetic Stimulation: A Systematic Review. American Journal of Medical Genetics Part B: Neuropsychiatric. 2026; 201: 9\u201329.","DOI":"10.1002\/ajmg.b.33051"},{"key":"ref78","doi-asserted-by":"publisher","unstructured":"Vigne MM, Kweon J, Fukuda AM, Brown JC, Carpenter LL. The Role of Brain Derived Neurotrophic Factor Polymorphism in Transcranial Magnetic Stimulation Response for Major Depressive Disorder. The Journal of ECT. 2026; 42: 24\u201330.","DOI":"10.1097\/YCT.0000000000001123"},{"key":"ref79","doi-asserted-by":"publisher","unstructured":"Ioannidis JPA. Interpretation of tests of heterogeneity and bias in meta-analysis. Journal of Evaluation in Clinical Practice. 2008; 14: 951\u2013957.","DOI":"10.1111\/j.1365-2753.2008.00986.x"},{"key":"ref80","doi-asserted-by":"publisher","unstructured":"Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clinical Research Ed.). 2003; 327: 557\u2013560.","DOI":"10.1136\/bmj.327.7414.557"}],"container-title":["Journal of Integrative Neuroscience"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/JIN\/25\/9\/10.31083\/JIN49076","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:16:58Z","timestamp":1790698618000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/JIN\/25\/9\/10.31083\/JIN49076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":80,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1757-448X(26)04654-0"],"URL":"https:\/\/doi.org\/10.31083\/jin49076","relation":{},"ISSN":["0219-6352","1757-448X"],"issn-type":[{"value":"0219-6352","type":"print"},{"value":"1757-448X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"article-number":"49076"}}