gms | German Medical Science

71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Navigated repetitive transcranial magnetic stimulation improves the outcome of postsurgical ischemia-related paresis in glioma patients – a randomised, sham-controlled double-blinded trial

Navigierte repetitive transkranielle Magnetstimulation verbessert das Outcome von postoperativen, ischämie-bedingten Paresen in Gliom-Patienten – eine randomisierte, sham-kontrollierte Doppel-Blind-Studie

Meeting Abstract

  • presenting/speaker Sebastian Ille - Technische Universität München, München, Deutschland
  • Anna Kelm - Technische Universität München, München, Deutschland
  • Axel Schröder - Technische Universität München, München, Deutschland
  • Lucia Albers - Technische Universität München, München, Deutschland
  • Chiara Negwer - Technische Universität München, München, Deutschland
  • Vicki Butenschön - Technische Universität München, München, Deutschland
  • Nico Sollmann - Technische Universität München, München, Deutschland
  • Thomas Picht - Charité – Universitätsmedizin Berlin, Berlin, Deutschland
  • Peter Vajkoczy - Charité – Universitätsmedizin Berlin, Berlin, Deutschland
  • Bernhard Meyer - Technische Universität München, München, Deutschland
  • Sandro Krieg - Technische Universität München, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV298

doi: 10.3205/20dgnc294, urn:nbn:de:0183-20dgnc2945

Published: June 26, 2020

© 2020 Ille et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Navigated repetitive transcranial magnetic stimulation (nrTMS) is effective therapy for stroke patients. Neurorehabilitation could be supported by low-frequency stimulation of the non-damaged hemisphere to reduce transcallosal inhibition. The present study examines the effect of postoperative nrTMS therapy of the unaffected hemisphere in glioma patients suffering from acute surgery-related paresis of the upper extremity (UE) due to subcortical ischemia.

Methods: We performed a randomized, sham-controlled, double-blinded trial on patients suffering from acute surgery-related paresis of the UE after glioma resection. Patients were randomly assigned to receive either low-frequency nrTMS (1 Hz, 15 minutes) or sham stimulation directly before physical therapy for 7 consecutive days. We performed primary and secondary outcome measures on day 1, on day 7, and at a 3-month follow-up (FU). The primary endpoint was the change in Fugl-Meyer Assessment (FMA) at FU.

Results: Compared to the sham stimulation, nrTMS significantly improved outcomes between day 1 and FU based on the FMA (mean [95% CI] +31.9 [22.6, 41.3] vs. +4.2 [-4.1, 12.5]; P=0.001) and the National Institutes of Health Stroke Scale (NIHSS) (-5.6 [-7.5, -3.6] vs. -2.4 [-3.6, -1.2]; P=0.02). To achieve a minimal clinically important difference of 10 points on the FMA scale, the number needed to treat is 2.19.

Conclusion: The present results show that patients suffering from acute surgery-related paresis of the UE due to subcortical ischemia after glioma resection significantly benefit from low-frequency nrTMS stimulation therapy of the unaffected hemisphere.