AUTHOR=Li Jiamin , Chen Cen , Zhu Shenyu , Niu Xiulian , Yu Xidan , Ren Jie , Shen Min 

TITLE=Evaluating the Effects of 5-Hz Repetitive Transcranial Magnetic Stimulation With and Without Wrist-Ankle Acupuncture on Improving Spasticity and Motor Function in Children With Cerebral Palsy: A Randomized Controlled Trial

JOURNAL=Frontiers in Neuroscience

VOLUME=15

YEAR=2021

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2021.771064

DOI=10.3389/fnins.2021.771064

ISSN=1662-453X

ABSTRACT=<p><bold>Objective:</bold> The goal of this study is to explore the effect of wrist-ankle acupuncture combined with 5-Hz repetitive transcranial magnetic stimulation (rTMS) on improving spastic state and motor function of children with spastic cerebral palsy by measuring electrophysiological parameters and behaviors.</p><p><bold>Methods:</bold> Twenty-five children with spastic cerebral palsy were enrolled in a single-blind and randomized controlled trial. The control group received 20 sessions of 5-Hz rTMS over the affected hemisphere with 1,000 pulses. The experimental group was given wrist-ankle acupuncture on the basis of the control group. Gross motor function measure (GMFM-66), muscle tension, and electrophysiological parameters of the two groups were assessed at baseline and after intervention.</p><p><bold>Results:</bold> After treatment, the GMFM-66 scores in the same groups were significantly improved (<italic>p</italic> &lt; 0.001). Besides, the <italic>R</italic>-value of soleus, gastrocnemius, and hamstring muscle decreased (<italic>p</italic> &lt; 0.05), and the results showed a trend of shortening MEP latency, increasing amplitude and duration (<italic>p</italic> &lt; 0.05). Compared to the controlled group, the experimental group displayed more excellent changes in the GMFM-66 scores and motor evoked potential (MEP) latency. The statistical results showed that the increase of GMFM-66 score and the shortening of MEP latency in the experimental group were greater than that in the control group (<italic>p</italic> &lt; 0.05). However, no significant differences were found in the assessment of muscle tension, amplitude, and duration of MEPs between two groups (<italic>p</italic> &gt; 0.05).</p><p><bold>Conclusion:</bold> Wrist-ankle acupuncture combined with 5-Hz rTMS is optimal to improve gross motor function and enhance the conductivity of corticospinal tract in children with cerebral palsy but cannot highlight its clinical superiority in improving spasticity.</p><p><bold>Clinical Trial Registration:</bold> [<ext-link ext-link-type="uri" xlink:href="http://www.chictr.org.cn/index.aspx" xmlns:xlink="http://www.w3.org/1999/xlink">http://www.chictr.org.cn/index.aspx</ext-link>], identifier [chictr2000039495].</p>