Study on the Effects of rTMS Combined with Exercise Tasks on Brain Function in Stroke Patients Based on Microstate Analysis

FENG Jiawei, FU Lingdi, LI Shixing, HAO Man, LIANG Zhenhu, YIN Liyong

Acta Metrologica Sinica ›› 2026, Vol. 47 ›› Issue (4) : 622-632.

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Acta Metrologica Sinica ›› 2026, Vol. 47 ›› Issue (4) : 622-632. DOI: 10.3969/j.issn.1000-1158.2026.04.20

Study on the Effects of rTMS Combined with Exercise Tasks on Brain Function in Stroke Patients Based on Microstate Analysis

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Abstract

Repetitive transcranial magnetic stimulation (rTMS) generates induced currents through a time-varying magnetic field, which can regulate the neural excitability of post stroke movement disorder (PSMD) patients. The study recruited 38 participants, including 20 healthy participants and 18 stroke patients. Using rTMS stimulation of the primary motor cortex (M1) combined with motor task intervention, the impact on brain function was explored through electroencephalography (EEG) technology combined with relative power spectrum and microstate analysis.The results showed that after intervention, the behavioral scores of PSMD patients significantly increased (P<0.05), and the relative power of theta and gamma bands near the C3 electrode in the M1 region significantly decreased (P<0.05), approaching a healthy level. The parameters of microstate C increased significantly (P<0.05), while those of microstate E decreased significantly (P<0.05). High frequency band relative power and microstate C can serve as biomarkers for rTMS intervention, providing a new perspective for understanding the neural mechanisms by which rTMS improves motor function in stroke patients.

Key words

repetitive transcranial magnetic stimulation / electroencephalography / relative power spectrum / microstate analysis / stroke

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FENG Jiawei , FU Lingdi , LI Shixing , et al . Study on the Effects of rTMS Combined with Exercise Tasks on Brain Function in Stroke Patients Based on Microstate Analysis[J]. Acta Metrologica Sinica. 2026, 47(4): 622-632 https://doi.org/10.3969/j.issn.1000-1158.2026.04.20

References

[1]
WANG H G GUO J L ZHANG Y F, et al. Closed-Loop Rehabilitation of Upper-Limb Dyskinesia After Stroke: From Natural Motion to Neuronal Microfluidics[J]. Journal of NeuroEngineering and Rehabilitation202522(1): 87.
[2]
LI Z P QU Z J YIN B W, et al. Functional Connectivity Key Feature Analysis of Cognitive Impairment Patients Based on Microstate Brain Network[J]. Cerebral Cortex202434(2): bhae043.
[3]
LI X LYU J J LI R, et al. Single-cell Transcriptomic Analysis of the Immune Cell Landscape in the Aged Mouse Brain After Ischemic Stroke[J]. Journal of Neuroinflammation202219(1): 1-8.
[4]
FISHER J LANNIN N A ANDERSON C S, et al. Protocol for a Systematic and Scoping Review of Emergent Motion Capture Technology for Upper Extremity Assessment in Stroke[J]. Cerebrovascular Diseases202554(6):952-958.
[5]
ROSSI S ANTAL A BESTMANN S, et al. Safety and Recommendations for TMS Use in Healthy Subjects and Patient Populations, With Updates on Training, Ethical and Regulatory Issues: Expert Guidelines[J]. Clinical Neurophysiology2021132(1): 269-306.
[6]
SHERE S S MEHTA U M GIRIMAJI S C, Theta Burst Stimulation in Adolescent Depression: An Open-Label Evaluation of Safety, Tolerability, and Efficacy[J]. Brain Stimulation202114(4): 1051–1053.
[7]
MANSRE C G FREGNI F BOGGIO P S, et al. A Sham Controlled Trial of rTMS of the Unaffected Hemisphere in Stroke Patients[J]. Neurology200564(10): 1802–1804
[8]
SASAKI N MIZUTANI S KAKUDA W, et al. Comparison of the Effects of High-and Low-Frequency Repetitive Transcranial Magnetic Stimulation on Upper Limb Hemiparesis in the Early Phase of Stroke[J]. Journal of Stroke and Cerebrovascular Diseases201322(4): 413–418
[9]
QIU S WANG S P YI W B, et al. Changes of Resting-State EEG Microstates Induced by Low-Frequency Repetitive Transcranial Magnetic Stimulation[C]//IEEE Engineering in Medicine and Biology Society. Annual International Conference of the IEEE Engineering in Medicine and Biology Society, US, 2020: 3549–3552.
[10]
DING L L LIU H JING J, et al. Lesion Network Mapping for Neurological Deficit in Acute Ischemic Stroke. Annals of Neurology202394(3): 572–584.
[11]
李梅梅, 胡春海, 周影, 等. 基于改进注意力机制的认知障碍病程分类[J]. 计量学报202344(2): 296-303.
LI M M HU C H ZHOU Y, et al. Course Classific-ationof Cognitive Disorders Based on Improved AttentionMechanism[J]. Acta Metrologica Sinica202344(2): 296-303.
[12]
付荣荣, 孟云, 黄晓东, 等. 基于神经质量模型的运动想象脑电数据增强[J]. 计量学报202546(5): 762-768.
FU R R MENG Y HUANG X D, et al. Enhancement of Motor Imagery EEG Data Based on Neural Quality Model [J]. Acta Metrologica Sinica202546(5): 762-768
[13]
TANG Z Q HAN K Y WANG R R, et al. Excitatory Repetitive Transcranial Magnetic Stimulation Over the Ipsilesional Hemisphere for Upper Limb Motor Function After Stroke: A Systematic Review and Meta-Analysis. Frontiers in Neurology202213(6): 918597
[14]
YAN M H LUO Y HOU Y L, et al. Is Acupuncture Combined With Repeated Transcranial Magnetic Stimulation More Effective in Improving Upper Limb Motor Dysfunction After Stroke? A Systematic Review and Meta-Analysis of Randomized Controlled Trials[J]. Frontiers in Neurology202516(6): 1575879
[15]
CORTI M PATTEN C TRIGGS W. Repetitive Transcranial Magnetic Stimulation of Motor Cortex After Stroke: A Focused Review[J]. American Journal of Physical Medicine & Rehabilitation201291(3): 254–270.
[16]
付荣荣, 梁海, 米瑞甫. 运动意图诱发脑电预备响应信号的特征识别[J]. 计量学报202344(10): 1597-1601.
FU R R LIANG H F MI R F. Feature identifcation of EEG preparatory response signals evoked by motorintention [J]. Acta Metrologica Sinica202344(10): 1597-1601.
[17]
LU H Y MA Z Z ZHANG J P, et al. Altered Resting-State Electroencephalogram Microstate Characteristics in Stroke Patients[J]. Journal of Integrative Neuroscience202423(9):176.
[18]
ROCCHI L DI SANTO A BROWN K, et al. Disentangling EEG Responses to TMS Due to Cortical and Peripheral Activations. Brain Stimulation202114(1): 4-18.
[19]
VUCIC S STANLEY CHEN K H KIERNAN M C, et al. Clinical Diagnostic Utility of Transcranial Magnetic Stimulation in Neurological Disorders. Updated Report of an IFCN Committee[J]. Clinical Neurophysiology2023150(6): 131-175.
[20]
ROWE V BLANTON S AYCOCK D, et al. Remote Delivery of the Fugl-Meyer Assessment for the Upper Extremity: A Pilot Study to Assess Feasibility, Reliability, and Validity[J]. Archives of Rehabilitation Research and Clinical Translation20235(2): 100261.
[21]
CROCE P SPADONE S ZAPPASODI F, et al. rTMS Affects EEG Microstates Dynamic During Evoked Activity[J]. Cortex2021138(5): 302-310.
[22]
DI GIACOMO J GONGOR M SILVA F, et al. Repetitive Transcranial Magnetic Stimulation Changes Cognitive/Motor Tasks Performance: An Absolute Alpha and Beta Power Study[J]. Neuroscience Letters2021753(5): 135866.
[23]
CHEN Y N HAN X LI Y, et al.Electroencephalogram Microstate Analysis in Temporal Lobe Epilepsy: A Comparative Study With and Without Anxiety[J]. Seizure2025130(8): 92-99.
[24]
TSCHERPEL C DERN S HENSEL L, et al. Brain Responsivity Provides an Individual Readout for Motor Recovery After Stroke[J]. Brain2020143(6): 1873–1888.
[25]
HAMAGUHI T, ABO M. Recovery of Patients With Upper Limb Paralysis Due to Stroke Who Underwent Intervention Using Low-Frequency Repetitive Transcranial Magnetic Stimulation Combined With Occupational Therapy: A Retrospective Cohort Study[J]. Neuromodulation202326(4): 861–877.
[26]
WANG C S ZHANG Q ZHANG L L, et al. Comparative Efficacy of Different Repetitive Transcranial Magnetic Stimulation Protocols for Lower Extremity Motor Function in Stroke Patients: A Network Meta-Analysis[J]. Frontiers in Neuroscience202418(2): 1352212.
[27]
MARTINO CINNERA A CASULA E P PEZZOPANE V, et al. Association of TMS-EEG Interhemispheric Imbalance With Upper Limb Motor Impairment in Chronic Stroke Patients: An Exploratory Study[J]. Clinical Neurophysiology2025171(3): 195-106.
[28]
FANG F GODLEWSKA B CHO R Y, et al. Personalizing Repetitive Transcranial Magnetic Stimulation for Precision Depression Treatment Based on Functional Brain Network Controllability and Optimal Control Analysis[J]. NeuroImage2022260(10): 119465.
[29]
刘靖文, 尚万余, 张立红. 脑卒中后睡眠结构及睡眠-觉醒周期的改变[J]. 中风与神经疾病杂志202239(3): 235-237.
LIU J W SHANG W Y ZHANG L H. Changes in sleep structure and sleep wake cycle after stroke [J]. Journal of Apoplexy and Nervous Diseases202239(3): 235-237.
[30]
ZHANG J J Y, ANG J, SAFFAIR S E, et al. Repetitive Transcranial Magnetic Stimulation for Motor Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials With Low Risk of Bias[J]. Neuromodulation: Technology at the Neural Interface202528(1): 16-42.
[31]
YIN M Y LIU Y W ZHANG L Y, et al. Effects of rTMS Treatment on Cognitive Impairment and Resting-State Brain Activity in Stroke Patients: A Randomized Clinical Trial[J]. Frontiers in Neural Circuits202014(9): 563777.
[32]
WANG H L YIN N XU G Z. Advances in Methods and Applications of Electroencephalogram Microstate Analysis. Journal of Biomedical Engineering202340(1): 163-170.
[33]
ZHANG H M YANG X YAO L Q, et al. EEG Microstates Analysis After TMS in Patients With Subacute Stroke During the Resting State[J]. Cerebral Cortex. 202434(1): bhad480.
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