{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:01:46Z","timestamp":1793318506900,"version":"4.5.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Repetitive transcranial magnetic stimulation (rTMS) can improve post stroke motor function. However, there is little research on targets. The purpose of this study is to investigate the effects of rTMS therapy with different targets on post stroke motor function and neural plasticity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-four subjects were randomly divided into M1 (Primary motor area) group, SMA (supplementary motor area) group and Sham group, and were given 10\u2009Hz on the affected M1 area, SMA area and sham stimulation rTMS. The primary outcomes included Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE), Fugl-Meyer Assessment Lower Extremity Scale (FMA-LE) and Berg balance scale (BBS). Secondary outcomes: amplitude of low frequency fluctuation (ALFF), regional homogeneity (ReHo) and functional connectivity (FC) were analyzed by functional magnetic resonance imaging (fMRI) to evaluate brain functional activation and functional connectivity changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 2-way repeated-measures ANOVA revealed a significant group\u2009\u00d7\u2009time interaction (\n                      <jats:italic>F<\/jats:italic>\n                      \u2009=\u200923.494,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001;\n                      <jats:italic>F<\/jats:italic>\n                      \u2009=\u200910.801,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001;\n                      <jats:italic>F<\/jats:italic>\n                      \u2009=\u200917.812,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) in the FMA-UE, FMA-LE and BBS scores.\n                      <jats:italic>Post hoc<\/jats:italic>\n                      analysis indicated that 4\u2009weeks of SMA rTMS resulted in an increase in FMA-UE, FMA-LE and BBS scores compared with Sham group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), SMA group was significantly increased in BBS compared with M1 group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). Moreover, there were significant effects of time in all 3 groups in the FMA-UE, FMA-LE and BBS scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). In addition, the increase of ALFF in the supramarginal gyrus on the affected side was correlated with better FMA-UE recovery, the increase of ALFF in the middle temporal gyrus and the middle frontal gyrus on the affected side was positively correlated with the improvement of BBS, and the ALFF in the cerebellum on the healthy side was negatively correlated with the improvement of BBS. There was a positive correlation between FC (SMA \u2013 ipsilateral cerebellum) changes and BBS changes in SMA group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In conclusion, SMA-rTMS intervention has a better recovery effect on motor dysfunction after stroke than Sham-rTMS. SMA-rTMS led to similar improvement on motor function but significantly greater improvement on balance compared to M1-rTMS, and this may pave a new way for stroke rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      Registration number: ChiCTR2200060955,\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2024.1454220","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:44:55Z","timestamp":1727657095000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Effects of repetitive transcranial magnetic stimulation at different targets on brain function in stroke patients: a randomized controlled trial"],"prefix":"10.3389","volume":"15","author":[{"given":"Li","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sha","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxiao","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"S6","DOI":"10.1212\/WNL.0000000000012781","article-title":"Global epidemiology of stroke and access to acute ischemic stroke interventions","volume":"97","author":"Saini","year":"2021","journal-title":"Neurology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/S1474-4422(18)30499-X","article-title":"Global, regional, and national burden of neurological disorders, 1990\u20132016: a systematic analysis for the global burden of disease study 2016","volume":"18","author":"Collaborators","year":"2019","journal-title":"Lancet Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"616","DOI":"10.11622\/smedj.2019158","article-title":"Long-term complications of stroke and secondary prevention: an overview for primary care physicians","volume":"60","author":"Chohan","year":"2019","journal-title":"Singapore Med J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1016\/S1388-2457(00)00373-4","article-title":"Neurophysiological follow-up of motor cortical output in stroke patients","volume":"111","author":"Traversa","year":"2000","journal-title":"Clin Neurophysiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1177\/1545968312440745","article-title":"Getting neurorehabilitation right: what can be learned from animal models?","volume":"26","author":"Krakauer","year":"2012","journal-title":"Neurorehabil Neural Repair"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1002\/ana.21393","article-title":"Repairing the human brain after stroke: I. 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