Academic literature on the topic 'Ipsilesional stimulation'
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Journal articles on the topic "Ipsilesional stimulation"
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Vahdat, Shahabeddin, Arjun Vivek Pendharkar, Terrance Chiang, Sean Harvey, Haruto Uchino, Zhijuan Cao, Anika Kim, et al. "Brain-wide neural dynamics of poststroke recovery induced by optogenetic stimulation." Science Advances 7, no. 33 (August 2021): eabd9465. http://dx.doi.org/10.1126/sciadv.abd9465.
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Poststroke optogenetic stimulations can promote functional recovery. However, the circuit mechanisms underlying recovery remain unclear. Elucidating key neural circuits involved in recovery will be invaluable for translating neuromodulation strategies after stroke. Here, we used optogenetic functional magnetic resonance imaging to map brain-wide neural circuit dynamics after stroke in mice treated with and without optogenetic excitatory neuronal stimulations in the ipsilesional primary motor cortex (iM1). We identified key sensorimotor circuits affected by stroke. iM1 stimulation treatment restored activation of the ipsilesional corticothalamic and corticocortical circuits, and the extent of activation was correlated with functional recovery. Furthermore, stimulated mice exhibited higher expression of axonal growth–associated protein 43 in the ipsilesional thalamus and showed increased Synaptophysin+/channelrhodopsin+ presynaptic axonal terminals in the corticothalamic circuit. Selective stimulation of the corticothalamic circuit was sufficient to improve functional recovery. Together, these findings suggest early involvement of corticothalamic circuit as an important mediator of poststroke recovery.
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Cunningham, David A., Jayme S. Knutson, Vishwanath Sankarasubramanian, Kelsey A. Potter-Baker, Andre G. Machado, and Ela B. Plow. "Bilateral Contralaterally Controlled Functional Electrical Stimulation Reveals New Insights Into the Interhemispheric Competition Model in Chronic Stroke." Neurorehabilitation and Neural Repair 33, no. 9 (July 18, 2019): 707–17. http://dx.doi.org/10.1177/1545968319863709.
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Background. Upper-limb chronic stroke hemiplegia was once thought to persist because of disproportionate amounts of inhibition imposed from the contralesional on the ipsilesional hemisphere. Thus, one rehabilitation strategy involves discouraging engagement of the contralesional hemisphere by only engaging the impaired upper limb with intensive unilateral activities. However, this premise has recently been debated and has been shown to be task specific and/or apply only to a subset of the stroke population. Bilateral rehabilitation, conversely, engages both hemispheres and has been shown to benefit motor recovery. To determine what neurophysiological strategies bilateral therapies may engage, we compared the effects of a bilateral and unilateral based therapy using transcranial magnetic stimulation. Methods. We adopted a peripheral electrical stimulation paradigm where participants received 1 session of bilateral contralaterally controlled functional electrical stimulation (CCFES) and 1 session of unilateral cyclic neuromuscular electrical stimulation (cNMES) in a repeated-measures design. In all, 15 chronic stroke participants with a wide range of motor impairments (upper extremity Fugl-Meyer score: 15 [severe] to 63 [mild]) underwent single 1-hour sessions of CCFES and cNMES. We measured whether CCFES and cNMES produced different effects on interhemispheric inhibition (IHI) to the ipsilesional hemisphere, ipsilesional corticospinal output, and ipsilateral corticospinal output originating from the contralesional hemisphere. Results. CCFES reduced IHI and maintained ipsilesional output when compared with cNMES. We found no effect on ipsilateral output for either condition. Finally, the less-impaired participants demonstrated a greater increase in ipsilesional output following CCFES. Conclusions. Our results suggest that bilateral therapies are capable of alleviating inhibition on the ipsilesional hemisphere and enhancing output to the paretic limb.
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Kakinoki, Ryosuke, Scott F. M. Duncan, Ryosuke Ikeguchi, Souichi Ohta, Manabu Nankaku, Hiroshi Sakai, Takashi Noguchi, Yukitoshi Kaizawa, and Masao Akagi. "Motor and Sensory Cortical Changes after Contralateral Cervical Seventh Nerve Root (CC7) Transfer in Patients with Brachial Plexus Injuries." Journal of Hand Surgery (Asian-Pacific Volume) 22, no. 02 (May 15, 2017): 138–49. http://dx.doi.org/10.1142/s0218810417500162.
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Background: Previous animal studies demonstrated that the sensory and motor functions in ipsilesional upper limbs that had been reconstructed by CC7 transfer eventually associated with the contralesional brain cortices that had originally mediated the functions of the ipsilesional upper limbs before brachial plexus injury (BPI). Our hypothesis was that the same findings would be seen in humans.Methods: Four patients with total BPI treated with CC7 transfer were included. Changes in the locations of the activated areas in the primary motor (M1) and somatosensory (S1) cortices corresponding to the motor outputs to and sensory inputs from the ipsilesional limbs were investigated using functional near-infrared spectroscopy (fNIRS) 2–3 years and 6–7 years after surgery.Results: One patient was excluded from the evaluation of motor function after CC7 transfer. The motor and sensory functions of the ipsilesional upper limb in all patients were still controlled by the ipsilesional brain hemisphere 2–3 years after CC7 transfer. The reconstructed motions of the ipsilesional upper limbs correlated with the contralesional M1 in one patient and the bilateral M1s in another patient (both of whom demonstrated good motor recovery in the ipsilesional upper limbs) and with the ipsilesional M1 in a third patient with poor motor recovery in the ipsilesional upper limb. Sensory stimulation of the ipsilesional hands 6–7 years after CC7 transfer activated the contralesional S1 in two patients who achieved good sensory recovery in the ipsilesional hands but activated the ipsilesional S1 in the other two patients with poor sensory recovery of the ipsilesional hands.Conclusions: Transhemispheric transposition of the activated brain cortices associated with the recovery of motor and sensory functions of the ipsilesional upper limbs was seen in patients with CC7 transfer as has been reported for animal models of CC7 transfer.
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Juan Du, Weihe Yao, Jianrui Li, Fang Yang, Jingze Hu, Qiang Xu, Ling Liu, et al. "Motor Network Reorganization After Repetitive Transcranial Magnetic Stimulation in Early Stroke Patients: A Resting State fMRI Study." Neurorehabilitation and Neural Repair 36, no. 1 (October 28, 2021): 61–68. http://dx.doi.org/10.1177/15459683211054184.
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Objective To compare the effects of high-frequency (10 Hz) versus low-frequency (1 Hz) repetitive Transcranial Magnetic Stimulation (rTMS) on motor recovery and functional reorganization of the cortical motor network during the early phase of stroke. Methods Forty-six hospitalized, first-ever ischemic stroke patients in early stage (within two weeks) with upper limb motor deficits were recruited. They were randomly allocated to three groups with 10 Hz ipsilesional rTMS, 1 Hz contralesional rTMS, and sham rTMS of five daily session. All patients underwent motor function (Upper Extremity Fugl–Meyer), neurophysiological and resting-state functional Magnetic Resonance Imaging (fMRI) (rs-fMRI) assessments before and after rTMS intervention. Motor recovery (△Fugl–Meyer Assessment) was defined as motor function changes before and after rTMS intervention. Motor function assessment was reevaluated at time point of three month follow-up. Results The two real rTMS groups manifested greater motor improvements than the sham group. The effect sustained for at least 3 months after the end of the treatment sessions. Compared with the sham group, 10 Hz ipsilesional rTMS group presented increased resting-state functional connectivity (FC) between ipsilesional primary motor cortex (M1) and contralesional M1 (P = .007), whereas 1 Hz contralesional rTMS group presented increased FC between contralesional M1 and ipsilesional supplementary motor area (P = .010), which were positively correlated with motor recovery (P < .05). Conclusion Beneficial effect of rTMS on motor recovery might be underlaid by increased FC between stimulating site and the remote motor areas, highlighting the motor network reorganization mechanism of rTMS in early post-stroke phase.
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Guo, Zhiwei, Yu Jin, Xi Bai, Binghu Jiang, Lin He, Morgan A. McClure, and Qiwen Mu. "Distinction of High- and Low-Frequency Repetitive Transcranial Magnetic Stimulation on the Functional Reorganization of the Motor Network in Stroke Patients." Neural Plasticity 2021 (January 20, 2021): 1–11. http://dx.doi.org/10.1155/2021/8873221.
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Objective. To investigate the functional reorganization of the motor network after repetitive transcranial magnetic stimulation (rTMS) in stroke patients with motor dysfunction and the distinction between high-frequency rTMS (HF-rTMS) and low-frequency rTMS (LF-rTMS). Methods. Thirty-three subcortical stroke patients were enrolled and assigned to the HF-rTMS group, LF-rTMS group, and sham group. Each patient of rTMS groups received either 10.0 Hz rTMS over the ipsilesional primary motor cortex (M1) or 1.0 Hz rTMS over the contralesional M1 for 10 consecutive days. A resting-state functional magnetic resonance imaging (fMRI) scan and neurological examinations were performed at baseline and after rTMS. The motor network and functional connectivities intramotor network with the core brain regions including the bilateral M1, premotor area (PMA), and supplementary motor area (SMA) were calculated. Comparisons of functional connectivities and Pearson correlation analysis between functional connectivity changes and behavioral improvement were calculated. Results. Significant motor improvement was found after rTMS in all groups which was larger in two rTMS groups than in the sham group. The functional connectivities of the motor network were significantly increased in bilateral M1, SMA, and contralesional PMA after real rTMS. These changes were only detected in the regions of the ipsilesional hemisphere in the HF-rTMS group and in the regions of the contralesional hemisphere in the LF-rTMS group. Significantly changed functional connectivities of the intramotor network were found between the ipsilesional M1 and SMA and contralesional PMA, between contralesional M1 and contralesional SMA, between contralesional SMA and ipsilesional SMA and contralesional PMA in the HF-rTMS group in which the changed connectivity between ipsilesional M1 and contralesional PMA was obviously correlated with the motor improvement. In addition, the functional connectivity of the intramotor network between ipsilesional M1 and contralesional PMA was significantly higher in the HF-rTMS group than in the LF-rTMS group. Conclusion. Both HF-rTMS and LF-rTMS have a positive effect on motor recovery in patients with subcortical stroke and could promote the reorganization of the motor network. HF-rTMS may contribute more to the functional connectivity reorganization of the ipsilesional motor network and realize greater benefit to the motor recovery.
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Guo, Xiaoli, Yongzhi He, Hongyang Lu, Yao Li, Xin Su, Ying Jiang, and Shanbao Tong. "Plastic Change along the Intact Crossed Pathway in Acute Phase of Cerebral Ischemia Revealed by Optical Intrinsic Signal Imaging." Neural Plasticity 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/1923160.
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The intact crossed pathway via which the contralesional hemisphere responds to the ipsilesional somatosensory input has shown to be affected by unilateral stroke. The aim of this study was to investigate the plasticity of the intact crossed pathway in response to different intensities of stimulation in a rodent photothrombotic stroke model. Using optical intrinsic signal imaging, an overall increase of the contralesional cortical response was observed in the acute phase (≤48 hours) after stroke. In particular, the contralesional hyperactivation is more prominent under weak stimulations, while a strong stimulation would even elicit a depressed response. The results suggest a distinct stimulation-response pattern along the intact crossed pathway after stroke. We speculate that the contralesional hyperactivation under weak stimulations was due to the reorganization for compensatory response to the weak ipsilateral somatosensory input.
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Zou, Fei, Yi-Fang Lin, Shu-Geng Chen, Lei Cao, Hao-ran Wang, Bin Ye, Qiang Wang, He Jie-Ying, and Jie Jia. "The Impact of Electroacupuncture at Hegu, Shousanli, and Quchi Based on the Theory “Treating Flaccid Paralysis by Yangming Alone” on Stroke Patients’ EEG: A Pilot Study." Evidence-Based Complementary and Alternative Medicine 2020 (November 24, 2020): 1–9. http://dx.doi.org/10.1155/2020/8839491.
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Background. In China, electroacupuncture based on meridians theory “treating flaccid paralysis by Yangming alone” has been widely used for stroke rehabilitation in clinical practice. The aim of this study was to explore the electroencephalography change of electroacupuncture intervention on strokes patients with flaccid paralysis. Methods. Twenty-three stroke patients with flaccid paralysis and six stroke patients with spasticity accepted electroacupuncture with the acupoints Hegu [LI4], Shousanli [LI10], and Quchi [LI11] for 20 minutes and their EEG data were recorded before, during, and after the electroacupuncture intervention. Results. Compared with the baseline EEG signals before electroacupuncture, the ipsilesional and contralesional beta-band average power of patients with flaccid paralysis and spasticity were significantly increased during the needles retention stage and decreased slightly after removing the needles. The significant decrease of the ipsilesional and contralesional delta band average power in patients with flaccid paralysis occurred during the electroacupuncture stimulation, and they increased after the removal of the needles. The ipsilesional delta band average power of patients with spasticity significantly decreased during the electroacupuncture stimulation. Conclusion. From this pilot electrophysiological study, we provided a possible electrophysiological mechanism of the curative effect of electroacupuncture for stroke rehabilitation.
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Kim, Young R., In J. Huang, Seong-Ryong Lee, Emiri Tejima, Joseph B. Mandeville, Maurits PA van Meer, George Dai, et al. "Measurements of BOLD/CBV Ratio Show Altered fMRI Hemodynamics during Stroke Recovery in Rats." Journal of Cerebral Blood Flow & Metabolism 25, no. 7 (March 9, 2005): 820–29. http://dx.doi.org/10.1038/sj.jcbfm.9600084.
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Brain responses to external stimuli after permanent and transient ischemic insults have been documented using cerebral blood volume weighted (CBVw) functional magnetic resonance imaging (fMRI) in correlation with tissue damage and neurological recovery. Here, we extend our previous studies of stroke recovery in rat models of focal cerebral ischemia by comparing blood oxygen level-dependent (BOLD) and cerebral blood volume (CBV) changes. Responses to forepaw stimulation were measured in normal rats ( n = 5) and stroke rats subjected to 2 h of middle cerebral artery occlusion ( n = 6). Functional magnetic resonance imaging was performed 2 weeks after stroke to evaluate the recovery process. After stroke, animals showed variable degrees of fMRI activation in ipsilesional cortex, the extent of which did not correlate with structural damages as measured using apparent diffusion coefficient, fractional anisotropy, blood volume, and vessel size index. While the contralesional cortex showed good overlap between BOLD and CBV-activated regions, the ipsilesional cortex showed low covariance between significantly activated voxels by BOLD and CBVw techniques. In particular, the relative activation during contralateral stimuli in the ipsilesional somatosensory cortex was significantly higher for CBVw responses than BOLD, which might be due to stroke-related alterations in fMRI hemodynamic coupling. Aberrant subcortical activations were also observed. When unaffected forelimbs were stimulated, strong bilateral responses were observed. However, little thalamic responses accompanied stimulation of affected forelimbs despite significant activation in the ipsilesional somatosensory cortex. These results suggest that stroke affects not only local hemodynamics and coupling but also other factors including neural connectivity.
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Ahn, Sung Min, Da Hee Jung, Hong Ju Lee, Malk Eun Pak, Young Jin Jung, Yong-Il Shin, Hwa Kyoung Shin, and Byung Tae Choi. "Contralesional Application of Transcranial Direct Current Stimulation on Functional Improvement in Ischemic Stroke Mice." Stroke 51, no. 7 (July 2020): 2208–18. http://dx.doi.org/10.1161/strokeaha.120.029221.
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Background and Purpose: The therapeutic use of transcranial direct current stimulation (tDCS), an adjuvant tool for stroke, induces long-term changes in cortical excitability, for example, the secretion of activity-dependent growth factors. We assessed the proper therapeutic configuration of high-definition tDCS (HD-tDCS) in the subacute stage of ischemic stroke and its underlying expression profiling of growth factors to propose a new method for ensuring better therapeutic effects. Methods: Male C57BL/6J mice were subjected to middle cerebral artery occlusion, after which repetitive HD-tDCS (20 minutes, 55 µA/mm 2 , charge density 66 000 C/m 2 ) was applied from subacute phases of their ischemic insult. Behavioral tests assessing motor and cognitive functions were used to determine suitable conditions and HD-tDCS stimulation sites. Gene expression profiling of growth factors and their secretion and activation were analyzed to shed light on the underlying mechanisms. Results: Anodal HD-tDCS application over the contralesional cortex, especially the motor cortex, was more effective than ipsilesional stimulation in attenuating motor and cognitive deficits. In the HD-tDCS application over the contralesional motor cortex, positive changes in Bmp8b , Gdf5 , Il4 , Pdgfa , Pgf , and Vegfb were observed in the ipsilesional site. The expression of GDF5 (growth/differentiation factor 5) and PDGFA (platelet-derived growth factor subunit A) tended to similarly increase in both ipsi- and contralesional striata. However, higher expression levels of GDF5 and PDGFA and their receptors were observed in the peri-infarct regions of the striatum after HD-tDCS, especially in PDGFA expression. A higher number of proliferating or newly formed neuronal cells was detected in ipsilesional sites such as the subventricular zone. Conclusions: Application of anodal HD-tDCS over the contralesional cortex may enhance beneficial recovery through the expression of growth factors, such as GDF5 and PDGFA, in the ipsilesional site. Therefore, this therapeutic configuration may be applied in the subacute stage of ischemic stroke to ameliorate neurological impairments.
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Guo, Zhiwei, Yu Jin, Haitao Peng, Guoqiang Xing, Xiang Liao, Yunfeng Wang, Huaping Chen, Bin He, Morgan A. McClure, and Qiwen Mu. "Ipsilesional High Frequency Repetitive Transcranial Magnetic Stimulation Add-On Therapy Improved Diffusion Parameters of Stroke Patients with Motor Dysfunction: A Preliminary DTI Study." Neural Plasticity 2016 (2016): 1–11. http://dx.doi.org/10.1155/2016/6238575.
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Purpose. The aim of this study was to evaluate the effects of high frequency repetitive transcranial magnetic stimulation (HF-rTMS) on stroke patients with motor dysfunction and to investigate the underlying neural mechanism.Methods. Fifteen stroke patients were assigned to the rTMS treatment (RT) group and conventional treatment (CT) group. Patients in the RT received 10 Hz rTMS stimulation on the ipsilesional primary motor cortex for 10 days plus conventional treatment of CT, which consisted of acupuncture and antiplatelet aggregation medication. Difference in fractional anisotropy (FA) between pretreatment and posttreatment and between two groups was determined. Correlations between FA values and neurological assessments were also calculated.Results. Both groups significantly improved the neurological function after treatment. rTMS-treated patients showed better improvement in Fugl-Meyer Assessment (FMA) score and increased FA value in motor-related white matter and gray matter cortices compared with CT-treated patients and pretreatment status. Besides, the increased FA value in the ipsilesional posterior limb of the internal capsule in RT group was significantly correlated with the improved FMA score.Significance. HF-rTMS could be a supplement therapy to CT in improving motor recovery in patients with stroke. And this benefit effect may be achieved through modulating the ipsilesional corticospinal tracts and motor-related gray matter cortices.
Dissertations / Theses on the topic "Ipsilesional stimulation"
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Conti, Emilia. "In vivo optical imaging of cortical plasticity induced by rehabilitation after stroke." Doctoral thesis, 2019. http://hdl.handle.net/2158/1152568.
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In my PhD thesis I have studied the changes in functional and structural plasticity induced by a photothrombotic stroke in mouse primary motor cortex. In order to dissect the multiple aspects consequent to the damage we exploit fluorescent imaging techniques that allow to investigate the functional and structural rearrangement of the cortex at different scale, from the entire hemisphere, with wide-field calcium imaging, up to the single synapse with two-photon microscopy.
To promote a functional recovery of the mouse forelimb we applied different rehabilitative strategies in order to both foster the stabilization of regions of the cortex linked to the stroke core, and stimulate the remodelling of peri-infarct areas. We took advantage of a robotic platform (M-Platform), developed by our collaborator in Pisa, to perform the rehabilitation of mouse forelimb through a repetitive motor training. Together with this approach we applied different strategies to mould cortical activity. We temporary inhibited the healthy primary motor cortex, with an intracortical injection of Botulin Neuro Toxin E, in order to counterbalance the iper-excitability of the healthy hemisphere and to promote the structural and functional remodelling of the peri-infarct cortex. This combined rehabilitative protocol promotes the recovery of cortical maps of activation during motor training and the rewiring of interhemispheric connectivity, both from functional and structural level. Then we applied an optogenetic approach as a pro-plasticizing treatment by stimulating with light the region of the cortex surrounding the damage. By coupling this treatment with an intense motor training on the M-Platform we observed a generalized recovery of forelimb functionality in terms of manual dexterity and cortical profiles of activation. In this study, we have shown that different rehabilitative protocols that combines repetitive motor training and neuronal modulation of specific cortical regions induce a synergic effect on neuronal plasticity that promotes the recovery of structural features of healthy neuronal networks.
Book chapters on the topic "Ipsilesional stimulation"
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Wong, Agnes. "Ocular Motor Disorders Caused by Lesions in the Cerebellum." In Eye Movement Disorders. Oxford University Press, 2008. http://dx.doi.org/10.1093/oso/9780195324266.003.0018.
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The vestibulocerebellum consists of the flocculus, ventral paraflocculus, nodulus, and uvula. ■ The flocculus receives inputs from the vestibular nucleus and nerve, nucleus prepositus hypoglossi (NPH), inferior olivary nucleus, cell groups of the paramedian tracts (PMT), nucleus reticularis tegmenti pontis (NRTP), and mesencephalic reticular formation. ■ The ventral paraflocculus receives inputs from contralateral pontine nuclei. ■ Project to ipsilateral superior and medial vestibular nuclei, and the y-group ■ Receive input from the medial and inferior vestibular nuclei, vestibular nerve, NPH, and inferior olivary nucleus ■ Project to the vestibular nuclei ■ The oculomotor vermis consists of parts of the declive, folium, tuber, and pyramis. ■ Receives inputs from the inferior olivary nucleus, vestibular nuclei, NPH, paramedian pontine reticular formation (PPRF), NRTP, and dorsolateral and dorsomedial pontine nuclei ■ Projects to the caudal fastigial nucleus ■ Stimulation of the Purkinje cells in the dorsal vermis elicits contralaterally directed saccades and smooth pursuit ■ Receives inputs from the dorsal vermis, inferior olivary nucleus, and NRTP ■ Decussates and projects via the uncinate fasciculus of the brachium conjunctivum to the contralateral PPRF, rostral interstitial nucleus of the medial longitudinal fasciculus, nucleus of the posterior commissure, omnipause neurons in nucleus raphe interpositus, the mesencephalic reticular formation, and superior colliculus ■ Neurons in the fastigial oculomotor region (FOR) fire during both ipsilateral and contralateral saccades. 1. The contralateral FOR neurons burst before the onset of saccade, and the onset of firing is not correlated with any property of the saccade. 2. Conversely, the time of onset for neurons in the ipsilateral FOR varies, with bursts occurring later for larger saccades. 3. Thus, the difference in time of onset between contralateral and ipsilateral FOR activity encodes the amplitude of saccades (i.e., the larger the difference in time of onset, the larger the saccade amplitude). Eye movement abnormalities in uncinate fasciculus lesion include hypometric ipsilesional saccades and hypermetric contralesional saccades (“contrapulsion”). Arnold-Chiari malformation is a malformation of the medullary–spinal junction with herniation of intracranial contents through the foramen magnum. The three types are illustrated in the figure below.
Conference papers on the topic "Ipsilesional stimulation"
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He, Yongzhi, Xiaoli Guo, Yao Li, Hongyang Lu, and Shanbao Tong. "Expansion of contralesional sensory representation to ipsilesional hindlimb stimulation in acute phase of ischemic stroke in rat model." In 2015 7th International IEEE/EMBS Conference on Neural Engineering (NER). IEEE, 2015. http://dx.doi.org/10.1109/ner.2015.7146768.
Full textReports on the topic "Ipsilesional stimulation"
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Hsiao, Ming-Yen, Yoo Jin Choo, I.-Chun Liu, Boudier-Revéret Mathieu, and Min Cheol Chang. Effect of Repetitive Transcranial Magnetic Stimulation on Post-stroke Dysphagia: Meta-analysis of Stimulation Frequency, Stimulation Site, and Timing of Outcome Measurement. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0005.
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Review question / Objective: Dysphagia is one of the most frequent sequelae after stroke. It can result in various complications, such as malnutrition, dehydration, aspiration pneumonia, and poor rehabilitation outcomes. Repetitive transcranial magnetic stimulation (rTMS) is reported to improve dysphagia after stroke; however, the details remain unclear. We evaluated the following rTMS parameters on post-stroke dysphagia: stimulation frequency (high frequency [≥3 Hz] or low frequency [1 Hz]), stimulation site (ipsilesional mylohyoid cortex or contralesional mylohyoid cortex), and outcome measurement timing (immediately, 3 weeks, and 4 weeks after the rTMS session).