Repetitive Transcranial Magnetic Stimulation in Cardiac Autonomic Dysfunction

Afyonkarahisar Health Sciences University

Status: Enrolling

Conditions: Stroke; Hemiparesis; Autonomic Dysfunction

Treatments: Device: Sham rTMS Protocol; Device: rTMS M1 Motor Cortex Protocol

Study type: Interventional

Funder types: Other

Identifiers

NCT07482501

TMSCAD2026

Details and patient eligibility

About

The aim of this study is to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) added to conventional neurological rehabilitation on heart rate variability (HRV), quality of life, upper extremity muscle strength and autonomic symptoms in patients with stroke.

Full description

Stroke is a leading cause of disability worldwide and is frequently associated with autonomic dysfunction (AD). AD can affect heart function, arterial blood pressure, fluid balance, and other body systems, negatively influencing clinical outcomes and prognosis. Brain damage in cortical and subcortical regions during stroke can disrupt the integrity of the central autonomic network, leading to AD. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method thought to support neuroplasticity and potentially improve autonomic function. This study aims to investigate the effects of rTMS on autonomic dysfunction and related functional parameters in patients with stroke.

Enrollment: 44 estimated patients

Sex: All

Ages: 35 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Participants aged 35-80 years admitted to the Afyonkarahisar Health Sciences University Hospital Physical Medicine and Rehabilitation Unit for neurological rehabilitation after stroke
• Participants with a history of stroke of at least 3 months
• Neurologically and medically stable participants willing to participate regularly in the study
• Participants capable of following commands

Exclusion criteria

• Serious cardiac disease, uncontrolled hypertension
• Epilepsy or history of antiepileptic drug use
• Intracranial metallic implants
• Inner ear implants
• Malignancy
• Active infection
• Skin infection or open wound in the intervention area
• Brain lesions or medications that may alter the seizure threshold
• Increased intracranial pressure
• Uncontrolled migraine
• Fracture or surgery on the hemiplegic side within the last 6 months
• Pregnancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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44 participants in 2 patient groups

First Group

Experimental group

Description:

In addition to the neurological rehabilitation program (5 days per week, for 4 weeks totaling 20 sessions) repetitive transcranial magnetic stimulation (rTMS) will be applied using the MagVenture MagPro R30 device, with a Figure Eight Coil, according to the study protocol. rTMS will be delivered to the contralateral primary motor cortex (M1) upper extremity motor area at a low frequency of 1 Hz, with 5 sessions per week for 4 weeks, totaling 20 sessions.

Treatment:

Device: rTMS M1 Motor Cortex Protocol

Second Group

Sham Comparator group

Description:

Participants will receive the neurological rehabilitation program in the same form and dosage as applied in the active group. In addition, sham (placebo) repetitive transcranial magnetic stimulation (rTMS) will be administered to mimic the procedure without delivering active stimulation.

Treatment:

Device: Sham rTMS Protocol