Case Report: StrokeHand Function Improvement with Low-Frequency Repetitive Transcranial Magnetic Stimulation of the Unaffected Hemisphere in a Severe Case of StrokeBoggio, Paulo S. MSc; Alonso-Alonso, Miguel MD, MSc; Mansur, Carlos G. MD; Rigonatti, Sergio P. MD, PhD; Schlaug, Gottfried MD; Pascual-Leone, Alvaro MD, PhD; Fregni, Felipe MD, PhDAuthor Information From the Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (MA-A, GS, AP-L, FF); the Department of Experimental Psychology and Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil (PSB, CGM); and Mackenzie University, Sao Paulo, Brazil (PSB). This work was supported by a grant from the Harvard Medical School Scholars in Clinical Science Program (NIH K30 HL04095) to Felipe Fregni. Pascual-Leone is supported by NIH grants R01-NS20068, R01-EB005047, and K24-RR018875. All correspondence and requests for reprints should be addressed to Felipe Fregni, MD, PhD; Harvard Center for Non-invasive Brain Stimulation, 330 Brookline Ave – KS 452, Boston, MA 02215. American Journal of Physical Medicine & Rehabilitation: November 2006 - Volume 85 - Issue 11 - p 927-930 doi: 10.1097/01.phm.0000242635.88129.38 Buy Metrics Abstract Boggio PS, Alonso-Alonso M, Mansur CG, Rigonatti SP, Schlaug G, Pascual-Leone A, Fregni F: Hand function improvement with low-frequency repetitive transcranial magnetic stimulation of the unaffected hemisphere in a severe case of stroke. Am J Phys Med Rehabil 2006;85:927–930. Previous research has shown that low-frequency rTMS of the unaffected hemisphere can improve motor function in acute and chronic stroke patients. However, these studies only investigated patients with mild or moderate motor deficits. We report a case of a stroke patient with a severe motor impairment who underwent sham and active repetitive transcranial magnetic stimulation (rTMS) of the unaffected hemisphere and had significantly improved motor function after active, but not after sham, stimulation of the unaffected primary motor cortex. In an additional session of active rTMS, this patient maintained and further enhanced the initial motor improvement. This case report shows that inhibitory rTMS of the unaffected hemisphere can also be beneficial for stroke patients with severe motor deficits and suggests that this approach of noninvasive brain stimulation should be further investigated in this population of patients. © 2006 Lippincott Williams & Wilkins, Inc.