Function-specific repetitive transcranial magnetic stimulation enhances motor strategy adaptation when combined with motor practice.

Clinical Snapshot

Key Findings

• P Value: Significant (exact values not provided)

• Effect Size: Not reported

• Primary Outcome: Trunk angle during glide phase of shot put movement

• Nnt Or Sensitivity: Not calculable from available data

• Confidence Interval: Not reported

Clinical Application

Requires specialized equipment (rTMS, fMRI) and trained personnel, limiting widespread implementation TGA-approved rTMS devices available; technique could be implemented in specialized rehabilitation centers and sports medicine facilities with appropriate neuroimaging capabilities Healthy adults requiring motor skill acquisition or adaptation, potentially applicable to stroke rehabilitation and sports performance

Abstract

Effective motor strategy adaptation is essential for both high-performance sports and neurorehabilitation. Repetitive transcranial magnetic stimulation (rTMS) can modulate brain function; however, its efficacy may depend on the specificity of the stimulation targets. This study investigated whether function-specific rTMS, guided by fMRI-defined activation during motor imagery, enhances motor strategy adaptation. Forty-six healthy adults were randomized into three groups: function-specific rTMS, hotspot rTMS, and a no-stimulation control. All participants received identical motor imagery and physical practice in the backward glide shot put. Kinematic and resting-state functional magnetic resonance imaging (rs-fMRI) data were collected before and after the 7-day intervention, and functional connectivity (FC) was analyzed. Results showed that function-specific rTMS led to significantly greater improvements in trunk angle during the glide phase, a critical biomechanical parameter. FC between the right inferior frontal gyrus (IFG) and primary sensorimotor cortex increased significantly in this group and was positively correlated with kinematic improvements. These findings demonstrate that rTMS targeting task-relevant brain regions enhances motor strategy adaptation via mechanisms involving FC associated with motor performance, highlighting its potential for optimizing motor learning in both athletic and clinical populations.