In an editorial published online in Neurology on December 14, 2011, Heidi M. Schambra, MD, and Randolph S. Marshall, MD, MS, discuss a study, also published in Neurology, on the use of transcranial magnetic stimulation (TMS) to treat the condition called “hemispatial neglect.” In TMS, an electromagnetic coil placed against the scalp creates electrical currents that painlessly stimulate nerve cells in the brain.
With hemispatial neglect, patients who have a stroke on one side of the brain are unable to focus their attention on the opposite side of the body or the world beyond, despite being able to feel and see normally. Most commonly, a stroke on the right side of the brain causes hemispatial neglect on the left side of the body.
The study, led by Giacomo Koch, MD, PhD, of the Santa Lucia Foundation in Rome, Italy, used TMS along with conventional rehabilitation. Improvement persisted two weeks after treatment ended, suggesting that changes to the brain had taken place at the cellular level.
Schambra and Marshall consider the study “an important step forward.” However, they point out the difficulty of separating the effect of TMS from that of rehabilitation. Stimulation alone, they say, is insufficient to cause significant neuroplasticity, but it may prime the nervous system to make better use of therapy.