Testing Benefits Of RTMS Therapy After Stroke

Ruzanna Harutyunyan's picture

People who have suffered aftereffects of a stroke are being encouraged to volunteer for a new study that will test the benefits of a therapy not previously used for stroke victims that excites neurons in the brain through magnetic stimulation.

The therapy, called reptitive Transcranial Magnetic Stimulation (rTMS), has been shown to help sufferers of neurological disorders like migraines, Parkinson's disease, dystonia and tinnitus. There are even indications it may be effective against psychiatric disorders like depression.

The study, called ENHANCE, is now under way in Montreal . Dr. Lisa Koski, director of the Transcranial Magnetic Stimulation Laboratory at the Royal Victoria Hospital leads the study and is actively recruiting local participants.


In Transcranial Magnetic Stimulation, rapidly changing magnetic fields are emitted from a small, plastic-covered coil placed against the head, which triggers activity in targeted areas of the brain. Repetitive Transcranial Magnetic Stimulation, or rTMS, is TMS therapy applied repeatedly over several minutes.

ENHANCE is the first large-scale study in Canada to look at the effects of rTMS on arm and hand mobility after a stroke. The whole study lasts 10 weeks, including three opening evaluation visits and an MRI scan, followed by four weeks of twice-weekly therapy and two final evaluation visits. All therapy and evaluations will be provided at no cost, and ENHANCE will assist participants with the cost of transportation to and from the Royal Victoria Hospital .

Following each rTMS treatment, participants will receive 90 minutes of standard physiotherapy and will be asked to perform everyday tasks to determine if hand and arm mobility has improved. Since the study is blind, by necessity some participants will receive real rTMS therapy, while others will receive simulated therapy, but everyone will receive real physiotherapy from a trained professional.

“If you've had a stroke affecting movement in your arm and hand but are otherwise healthy, we would like you to participate in this study,” said Dr. Koski, an assistant professor at McGill's Faculty of Medicine and a psychologist with extensive training in cognitive neuroscience. However, patients who cannot move any of their hand muscles on the affected side, who are subject to seizures or who have certain types of implants or metal in their heads are excluded from participation.

“New technologies are improving our understanding of how the brain adapts to injury and suggesting innovative approaches to rehabilitation”, Dr. Koski said. “We are very excited to contribute to research and development of rTMS as a promising new treatment for improving recovery of function after stroke.”