Effects of rTMS on grip force control following subcortical stroke.

Within the concept of interhemispheric competition we tested the effect of inhibitory 1 Hz repetitive transcranial magnetic stimulation (rTMS), applied over the primary motor cortex of the unaffected hemisphere, upon dexterity of the affected hand in subcortical stroke patients. Subjects grasped, lifted and held an instrumented object between the index finger and thumb with both the affected and unaffected hand prior to (baseline) and following 1 Hz rTMS applied over (i) the vertex (control stimulation) and (ii) the primary motor cortex of the unaffected hemisphere. Compared to baseline, 1 Hz rTMS applied over the unaffected primary motor cortex, but not the vertex, improved the efficiency and timing of grasping and lifting with the affected hand. Our data support the interhemispheric competition concept and furthermore reinforce current efforts to implement rTMS in novel approaches to stroke rehabilitation.