FROM BRAIN STIMULATION TO FUNCTIONAL RESTORATION: EVALUATING RTMS AND TDCS IN POST-STROKE MOTOR RECOVERY TRAJECTORIES juliopaza98@gmail.com

PW05-08

FROM BRAIN STIMULATION TO FUNCTIONAL RESTORATION: EVALUATING RTMS AND TDCS IN POST-STROKE MOTOR RECOVERY TRAJECTORIES

3

Mexico

Oral or Poster

Stroke is a major contributor to long-term disability globally, frequently affecting motor function and quality of life. Non-invasive brain stimulation techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), are being studied for their potential effects on neuroplasticity and motor recovery. This study aims to evaluate the effectiveness, safety, and optimal timing of rTMS and tDCS in routine clinical stroke rehabilitation.

We retrospectively analyzed data from 312 adults (1–6 months post-stroke, ischemic or hemorrhagic) treated at 11 centers from 2020 to 2024. Patients received rTMS (n=162) or tDCS (n=150) were evaluated. Motor recovery and functional status were assessed using the FMA and mRS at baseline and 8 weeks follow up.Adverse events and treatment adherence were carefully tracked.Group differences were analyzed using ANCOVA, and the durability of recovery was evaluated through Kaplan–Meier analysis. Bias risk was assessed with the ROBINS-I tool, while inter-center variability was measured using the I² statistic.

Among 312 patients, rTMS showed greater motor improvement (mean increase:17.6 ± 4.3)than tDCS(11.2 ± 3.9;p=0.01;95% CI: 2.1–10.1). More rTMS patients improved on the mRS (61.1% vs. 48.0%; p=0.012). Early treatment (<3 months) led to better outcomes. Over a 12-week period, rTMS gains lasted longer (logp=0.037).side effects included headache (8%) and scalp irritation (5%), with treatment adherence rates above 94%,and heterogeneity was low (I²=12.4%).

These results indicate that rTMS may offer greater motor recovery benefits than tDCS in post-stroke rehabilitation. Both treatments proving safe and well tolerated. Early use may enhance stroke recovery outcomes.