Repetitive transcranial magnetic stimulation to hemispatial neglect in patients after stroke: an open-label pilot study.

Abstract

OBJECTIVE: To test whether multiple sessions of inhibitory low-frequency repetitive transcranial magnetic stimulation (rTMS) applied to the left parietal area can improve hemispatial neglect after stroke. DESIGN: An open-label design. PATIENTS: Seven consecutive patients with hemispatial neglect after right hemispheric stroke were compared with 7 retrospectively recruited control patients. METHODS: Seven patients received a session of 1 Hz rTMS to the left parietal area immediately prior to occupational therapy for 10 days. Seven control patients received only behavioural therapy. RESULTS: Baseline values of the line bisection test and the Albert test were comparable in the two groups. The stimulation group showed a greater improvement in the line bisection test than did the control group. However, no differences were found between the two groups according to the Albert test. CONCLUSION: In this pilot study, low-frequency rTMS application to the non-affected left parietal area was found to be safe and to improve line bisection test, which suggests that non-invasive cortical stimulation has a potential role as an adjuvant strategy during cognitive rehabilitation training in patients with hemispatial neglect. A prospective randomized, sham-controlled study is required to determine the beneficial role of non-invasive cortical stimulation on hemispatial neglect.