• Bo Ryun Kim, Min Ho Chun, Dae-Yul Kim, and Sook Joung Lee.
• Department of Rehabilitation Medicine, Regional Cardiocerebrovascular Center, Jeju National University Hospital, University of Jeju School of Medicine, Jeju.
• Arch Phys Med Rehabil. 2013 May 1; 94 (5): 803-7.

ObjectiveTo compare the therapeutic effect of low- and high-frequency repetitive transcranial magnetic stimulation (rTMS) of the posterior parietal cortex (PPC) in patients with acute stroke with visuospatial neglect.DesignThis study was a prospective, double-blind, sham-controlled trial. Data are presented from 27 patients (15 men, 12 women; mean age, 67.0y) randomly assigned to receive 10 sessions of low-frequency (1Hz) rTMS over the nonlesioned PPC, high-frequency (10Hz) rTMS over the lesioned PPC, or sham stimulation.SettingNational university hospital.ParticipantsPatients (N=27) diagnosed with visuospatial neglect after stroke.InterventionTen sessions of rTMS over a 2-week period.Main Outcome MeasuresThe severity of visuospatial neglect was assessed pre- and posttreatment using the Motor-Free Visual Perception Test, line bisection test, star cancellation test, and Catherine Bergego Scale.ResultsWhen comparing the differences in the Motor-Free Visual Perception Test, line bisection test, star cancellation test, Catherine Bergego Scale, and Korean-Modified Barthel Index (K-MBI) scores before and after treatment according to group, we found that changes in the line bisection test and K-MBI scores were significantly different between 3 groups. In the post hoc analysis, the improvement in the line bisection test score in the high-frequency rTMS group was statistically significant compared with that in the sham stimulation group (high vs sham P=.03, low vs sham P=.09, high vs low P=.58), and the improvements in the K-MBI scores of the 2 rTMS groups were statistically significant compared with those in the sham stimulation group (high vs sham P<.01, low vs sham P=.02, high vs low P=.75).ConclusionsThese results indicate that high-frequency rTMS is effective in the treatment of visuospatial neglect in patients with acute stroke.Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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