Neuromodulatory Effect of Repetitive Transcranial Magnetic Stimulation Pulses on Functional Motor Performances of Spastic Cerebral Palsy Children

TITLE
Neuromodulatory Effect of Repetitive Transcranial Magnetic Stimulation Pulses on Functional Motor Performances of Spastic Cerebral Palsy Children

SOURCE
Journal of Medical Engineering & Technology. 42(5):352-358, 2018 Jul.

AUTHORS
Gupta M; Rajak BL; Bhatia D; Mukherjee A.

BACKGROUND
Neuromodulation is emerging as a new therapeutic field towards treatment of neurological disorders through advances in medical devices. Repetitive Transcranial Magnetic Stimulation (rTMS) is one such neuromodulatory device that has received increasing interest as a tool for modulating cortical excitability that influence motor activity in both normal and diseased population. However, the therapeutic effect of rTMS varies depending on stimulation frequency, intensity, pulse trains, duration, etc. Our previous studies had already demonstrated that higher frequency of 10 Hz was effective in improving the motor activity of spastic CP patients.

OBJECTIVE
This study was aimed to evaluate the effect of different rTMS pulses on gross motor performance of spastic CP patients.

METHOD
Thirty spastic CP patients were divided equally into three groups P1500, P2000 and P2500 with mean age (in years) 7.7 +/- SD4.4, 6.8 +/- SD5.3 and 7.2 +/- SD5.1 respectively. Gross Motor Function Measure (GMFM) was employed as an outcome measure to assess the motor performance. Constant rTMS frequency of 10 Hz was delivered to each participant but the number of stimulation pulse varied according to the groups; which were 1500, 2000 and 2500 pulses for P1500, P2000 and P2500 group respectively. rTMS therapy of 15 minutes duration was followed by physical therapy of 30 minutes daily for 20 days.

RESULT
Statistical analysis of pre versus post GMFM scores of different groups revealed significant result (p < .001) and the improvement in functional motor activity was 2.33% in P1500, 3.58% in P2000 and 5.17% in P2500 group.

INTERPRETATION
The result demonstrated modulatory effect of rTMS pulse by improving motor function of spastic CP patients.