Objective:

To systematically synthesize clinical research evidence regarding the combined use of TMS and fNIRS in post-stroke motor function recovery, emphasizing its significance in enhancing rehabilitation outcomes and analyzing its neurophysiological mechanisms, clinical efficacy, and methodological quality.

Approach:

Key Findings:

• The TMS-fNIRS combined protocol was found to be safe and feasible.
• Six out of nine interventional studies reported statistically significant improvements in motor function, such as Fugl-Meyer Assessment scores, particularly with interventions like intermittent theta-burst stimulation (iTBS) and high-frequency repetitive transcranial magnetic stimulation (rTMS).
• Effective TMS interventions could enhance activation of the ipsilesional primary motor cortex and improve interhemispheric balance.
• Two-thirds of the studies found significant correlations between neurophysiological changes and clinical function improvements.

Interpretation:

The combined TMS-fNIRS technology shows potential for advancing stroke rehabilitation toward individualization and closed-loop practice, suggesting a paradigm shift in therapeutic approaches.

Limitations:

• Small sample sizes in existing studies limit generalizability.
• High protocol heterogeneity complicates comparisons.
• Uneven methodological quality, particularly high risk of bias in non-randomized studies, affects the reliability of findings.

Conclusion:

Current evidence is still in the early stage, and future research should urgently focus on large-scale, standardized, algorithm-driven clinical trials to transition from 'proof-of-concept' to 'precision therapy'.

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This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.