P25.21 A computational model of the effects of training schedules in neurorehabilitation

Objectives: In the current randomized controlled trial (RCT) we used a form of repetitive TMS, theta burst stimulation (TBS), to study whether such stimulation could induce long-lasting modifications of LH circuits, and improve the functional recovery and clinical outcome of sub-acute stroke patients with neglect. Methods: We applied real or sham continuous TBS (cTBS) over the left PPC, for two weeks. Severity of neglect was assessed by means of the standardized behavioural inattention test (B.I.T.). In addition, we also measured, by means of bifocal transcranial magnetic stimulation (TMS), how cTBS modified the excitability of the parieto-frontal functional connections in the intact LH. Results: We found that two weeks of cTBS were effective in improving neglect syndrome as measured by B.I.T. Moreover, we also found that hyper-excitability of LH parieto-frontal circuits was reduced following treatment with real but not cTBS. All these effects were evident at the end of the two weeks of treatment and persisted even after one month. Conclusions: These findings suggest that a two-week course of cTBS of the PPC of the intact hemisphere may be effective in reducing visuospatial neglect in stroke patients.