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Journal of the Korean Academy of Rehabilitation Medicine 2011;35(2):180-187.
Effect of Premotor Cortex Stimulation on Motor Learning in Basal Ganglial Hemorrhage Patients.
Kang, Ga Young , Jung, Kwang Ik , Ohn, Suk Hoon , Yoo, Woo Kyoung
Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Anyang 431-070, Korea. wooky@hallym.ac.kr
To investigate the effects of high frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) on visuospatial motor learning, stimulated on the premotor cortex in basal ganglia hemorrhage patients. Method Nine patients were randomized to receive real and sham rTMS. We subdivided into two groups according to the integrity of the corticospinal tract measured by diffusion tensor tractography. The implicit visuospatial learning paradigm composed of numbers 1 to 4, in which 12 sequential numbers (2-3-1-4-3-2-4-1-3-4-2-1) were incorporated randomly. We obtained the mean fraction anisotrophy (FA) and apparent diffusion coefficient (ADC) values from the corticospinal tract and subdividing into two groups by calculating the relative value (laterality %).
rTMS on the premotor cortex was effective only in simple motor learning but not in visuospatial learning in group analysis. The primary motor cortex excitability after the premotor cortex stimulation has been changed significantly. Subdividing into two groups according to the integrity of the corticospinal tract using the ADC value, the low ADC value group showed significant reduction of the visuospatial response time. Conclusion High frequency rTMS on the premotor cortex was effective in simple motor learning and also in the group who maintained more integrity of the corticospinal tract in basal ganglia hemorrhage.
Key Words: Premotor cortex, Motor learning, RTMS, Tractography, Stroke


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