Exploratory research on the effects of repetitive transcranial magnetic stimulation (rTMS) on musculoskeletal biomarkers on stroke patients in Hospital Universiti Sains Malaysia

The leading cause of long-term disability caused by stroke is motor impairment. Neuroplasticity-induced cortical reorganization is a crucial process mediating motor recovery following stroke. Repetitive transcranial magnetic stimulation (rTMS) is a form of non-invasive brain stimulation approach tha...

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Main Author: Balakrishnan, Sri Ratha
Format: Thesis
Language:English
Published: 2019
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Online Access:http://eprints.usm.my/49518/1/Sri%20Ratha%20Balakrishnan-24%20pages.pdf
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spelling my-usm-ep.495182021-07-29T04:56:04Z Exploratory research on the effects of repetitive transcranial magnetic stimulation (rTMS) on musculoskeletal biomarkers on stroke patients in Hospital Universiti Sains Malaysia 2019-04 Balakrishnan, Sri Ratha R Medicine The leading cause of long-term disability caused by stroke is motor impairment. Neuroplasticity-induced cortical reorganization is a crucial process mediating motor recovery following stroke. Repetitive transcranial magnetic stimulation (rTMS) is a form of non-invasive brain stimulation approach that promotes neuroplasticity by modulating cortical excitability. We tested the effects of rTMS, when delivered over the ipsilesional hemisphere at the site of primary motor cortex (M1). Previous studies have reported elevated levels of serum Creatine Kinase (CK) and Troponin T among individuals with stroke. These serum enzymes are widely used as biomarkers for functional status of skeletal muscles. The aim of the present study is to assess the changes in the CK and Troponin T levels in response to 10 Hz rTMS in individuals with ischemic and hemorrhagic stroke. Eight stroke patients were screened according to inclusion and exclusion criteria. Subsequently, they were subjected to 10 sessions of fascilitatory protocol of rTMS on the ipsilesional hemisphere for a period of two weeks. The blood samples of the patients were obtained pre- and post-intervention in order to analyze the levels of CK and Troponin T. Statistical analysis revealed that there is no statistically significant difference in the median values of CK and Troponin T pre- and post-rTMS. Descriptive analysis indicated that the median values of CK and Troponin T at the baseline are higher than post-rTMS in this sample. In addition, stroke patients in the older age group were found to have higher levels of CK and Troponin T as compared to the younger patients. The considerable interindividual variability in CK and Troponin T activities among stroke patients can be ascribed to several confounding variables and relatively small sample size. Therefore, it can be suggested that future studies may include factors such as physical activity status, medical history of patients and types of medications in the analysis in order to assess the serum levels of aforementioned biomarkers, as a reliable indicator of muscle cells integrity following rTMS. 2019-04 Thesis http://eprints.usm.my/49518/ http://eprints.usm.my/49518/1/Sri%20Ratha%20Balakrishnan-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic R Medicine
spellingShingle R Medicine
Balakrishnan, Sri Ratha
Exploratory research on the effects of repetitive transcranial magnetic stimulation (rTMS) on musculoskeletal biomarkers on stroke patients in Hospital Universiti Sains Malaysia
description The leading cause of long-term disability caused by stroke is motor impairment. Neuroplasticity-induced cortical reorganization is a crucial process mediating motor recovery following stroke. Repetitive transcranial magnetic stimulation (rTMS) is a form of non-invasive brain stimulation approach that promotes neuroplasticity by modulating cortical excitability. We tested the effects of rTMS, when delivered over the ipsilesional hemisphere at the site of primary motor cortex (M1). Previous studies have reported elevated levels of serum Creatine Kinase (CK) and Troponin T among individuals with stroke. These serum enzymes are widely used as biomarkers for functional status of skeletal muscles. The aim of the present study is to assess the changes in the CK and Troponin T levels in response to 10 Hz rTMS in individuals with ischemic and hemorrhagic stroke. Eight stroke patients were screened according to inclusion and exclusion criteria. Subsequently, they were subjected to 10 sessions of fascilitatory protocol of rTMS on the ipsilesional hemisphere for a period of two weeks. The blood samples of the patients were obtained pre- and post-intervention in order to analyze the levels of CK and Troponin T. Statistical analysis revealed that there is no statistically significant difference in the median values of CK and Troponin T pre- and post-rTMS. Descriptive analysis indicated that the median values of CK and Troponin T at the baseline are higher than post-rTMS in this sample. In addition, stroke patients in the older age group were found to have higher levels of CK and Troponin T as compared to the younger patients. The considerable interindividual variability in CK and Troponin T activities among stroke patients can be ascribed to several confounding variables and relatively small sample size. Therefore, it can be suggested that future studies may include factors such as physical activity status, medical history of patients and types of medications in the analysis in order to assess the serum levels of aforementioned biomarkers, as a reliable indicator of muscle cells integrity following rTMS.
format Thesis
qualification_level Master's degree
author Balakrishnan, Sri Ratha
author_facet Balakrishnan, Sri Ratha
author_sort Balakrishnan, Sri Ratha
title Exploratory research on the effects of repetitive transcranial magnetic stimulation (rTMS) on musculoskeletal biomarkers on stroke patients in Hospital Universiti Sains Malaysia
title_short Exploratory research on the effects of repetitive transcranial magnetic stimulation (rTMS) on musculoskeletal biomarkers on stroke patients in Hospital Universiti Sains Malaysia
title_full Exploratory research on the effects of repetitive transcranial magnetic stimulation (rTMS) on musculoskeletal biomarkers on stroke patients in Hospital Universiti Sains Malaysia
title_fullStr Exploratory research on the effects of repetitive transcranial magnetic stimulation (rTMS) on musculoskeletal biomarkers on stroke patients in Hospital Universiti Sains Malaysia
title_full_unstemmed Exploratory research on the effects of repetitive transcranial magnetic stimulation (rTMS) on musculoskeletal biomarkers on stroke patients in Hospital Universiti Sains Malaysia
title_sort exploratory research on the effects of repetitive transcranial magnetic stimulation (rtms) on musculoskeletal biomarkers on stroke patients in hospital universiti sains malaysia
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Perubatan
publishDate 2019
url http://eprints.usm.my/49518/1/Sri%20Ratha%20Balakrishnan-24%20pages.pdf
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