January 8, 2021

For Immediate Release


OTTAWA, Jan. 8 2021 _ Canadian experts have produced the first set of recommendations on repetitive transcranial magnetic stimulation (rTMS) as an adjunct treatment to standard rehabilitation in clinical trials to help restore hand and arm use after stroke. The recommendations are in the latest issue of the journal Neurorehabilitation and Neural Repair.

Used in combination with physical therapy, TMS is a safe, noninvasive method to prime the brain by delivering short magnetic pulses on the outside of the skull. Repetitive TMS (rTMS) has the potential to enhance recovery and reduce the amount of standard therapy required to regain use of a stroke-affected limb.

Until now, the use of rTMS in stroke rehabilitation trials has been limited because there is no consensus on how and when to use it, the type of physical therapy to be combined with rTMS, who is most likely to benefit, and how to measure the impact.

“The purpose of our work was to develop recommendations for a comprehensive clinical trials protocol for the investigation of the efficacy of rTMS as an adjunct to physiotherapy in stroke rehabilitation clinical trials,” says Dr. Jodi Edwards, Director of the Brain and Heart Nexus Research Program at the University of Ottawa Heart Institute.

Along with stroke neurologist Dr. Alexander Thiel of McGill University and Dr. Numa Dancause of the Université de Montréal, Dr. Edwards co-leads the newly-formed Canadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim), a major national initiative that aims to facilitate multi-centre clinical trials for noninvasive brain stimulation interventions after stroke. CanStim involves top stroke recovery researchers from Ottawa, Montreal, Quebec City, Kingston, Vancouver, Calgary and St. John’s.

The recommendations, posted online yesterday in advance of publication of the February issue of the journal, identify the patients who would most benefit based on stroke location and severity, the timing of treatment, the type of rehabilitation to pair with brain stimulation, intensity and duration of stimulation, dose and duration of therapy, the use of biomarkers, and how to measure patient outcomes. Read the publication here: https://journals.sagepub.com/eprint/T2D7JNEFFXWN6ZANGZXZ/full

“Moving from proof-of-principle to large-scale clinical trials is a necessary next step toward recognition of rTMS as a standard therapeutic option for stroke rehabilitation,” says Dr. Thiel. “We are working to build trial capacity in this field – nationally and internationally – to enable the translation of noninvasive brain stimulation technologies, from the laboratory to clinical practice for stroke rehabilitation.”

A consensus conference to develop these recommendations  was funded by the Canadian Stroke Trials for Optimized Results (CaSTOR), a joint initiative of the Canadian Stroke Consortium and Heart & Stroke Foundation Canadian Partnership for Stroke Recovery.

More than 405,000 Canadians live with long-term disability from stroke and the number will double in 20 years.