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. 2023 Jun 19;14:1192545. doi: 10.3389/fneur.2023.1192545

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Copyright © 2023 Cheng, Xin, Zhao, Wang, Feng and Liu.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Description of the neurobiological model of rTMS as an treatment for stroke recovery. (A) Damage to one hemisphere in stroke results not only from neuronal loss within the affected hemisphere but also from the downregulation of remaining neurons within the affected hemisphere resulting in increased inhibition of the affected hemisphere by the unaffected hemisphere. Both are likely involved in lack of functional recovery. (B) High-frequency rTMS applied over the ipsilesional hemisphere strengthens the descending motor pathway, facilitating motor recovery. (C) Low-frequency rTMS applied over the contralesional hemisphere reduces inhibitory signals from the contralesional motor cortex, promoting beneficial cortical reorganization and motor recovery. Figure was modified from Servier Medical Art (http://smart.servier.com/), licensed under a Creative Common Attribution 3.0 Generic License. (https://creativecommons.org/Iicenses/by/3.0/) .