A Clinical Randomized Controlled Study of Low-Frequency rTMS Therapy on Lower Limb Motor Dysfunction after Stroke

Objective:To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)for the treatment of lower limb motor dysfunction after stroke.Methods:A total of 96 patients with stroke and lower limb motor dysfunction were enrolled in this study,and were randomly divided into the experimental group and the sham stimulation group using the method of calculator-generated random numbers.Both groups received conventional medication and rehabilitation therapy.The experimental group received 4 weeks of 1 Hz rTMS treatment in the primary cortical motor area(M1)of the healthy side,with the treatment coil tangent to the skull surface;the sham stimulation group underwent the same procedures as the experimental group,but the treatment coil was perpendicular to the skull surface instead.Lower-extremity subscale of the Fugl-Meyer Assessment(FMA-LE),Berg Balance Scale(BBS),gait analysis,and lower-extremity surface electromyography(LESEM)were performed in both groups before and after rTMS treatment.Results:All 96 patients completed the test with no shedding and no adverse reactions.After treatment,the FMA-LE score and BBS score of the 2 groups of patients were significantly improved as compared with the pre-treatment(P<0.05),and the TUG test time was reduced as compared with the pre-treatment(P<0.05).The true stimulation group had greater improvement in all assessment indexes than that of the sham stimulation group(P<0.05).After treatment,the electromyographic activity of the tibialis anterior and rectus femoris muscles in the true simulation group improved significantly.The step length,step speed,and step frequency were also significantly improved in both groups after treatment,and the symmetrical ratio of step length and support time was reduced(P<0.05).Comparison between the groups revealed that the true simulation group significantly improved after rTMS treatment as compared to the sham stimulation group(P<0.05).Conclusion:1Hz rTMS treatment safely and effectively improved motor and balance function in patients with post-stroke lower limb motor dysfunction.

Organized Warm-Sector Rainfall in the Coastal Region of South China in an Anticyclone Synoptic Situation:Observational Analysis

Organized warm-sector rainfall(OWSR)near the coast of South China tends to occur in certain synoptic situations characterized with either a low-level jet or an anticyclone,with the latter being less investigated.This paper fills the gap by analyzing 15 OWSR events that occurred in an anticyclone synoptic situation during the pre-summer rainy season of 2011-2016,based on high-resolution observational and reanalysis data.The results show that the anticyclone synoptic situation produces marked northerly boundary-layer winds inland and obvious northeasterly,easterly/southwesterly,and southeasterly boundary-layer winds near the coasts of eastern Guangdong,western Guangdong,and Guangxi,respectively.The coastal boundary-layer winds promote favorable environmental conditions and strong convergence for convection initiation;consequently,OWSR is prone to occur near the coasts of western Guangdong and Guangxi,but exhibits different formation and propagation features in the following two subareas.(1)The southeasterly boundary-layer winds tend to converge near the border area between Guangxi and Guangdong(BGG),promoting the formation of a stable convective line along the mountains.The convective line persists with support of upper-level southwesterly winds that facilitate convective cells to propagate along the convective line,producing heavy OWSR along the mountains near BGG.(2)In contrast,a west-east convective line tends to form and maintain near the coast of Yangjiang(YJ)area,about 200 km east of BGG,owing to stable convergence between the easterly(or southwesterly)and the northerly boundary-layer winds reinforced by the mountains near YJ.Moreover,the coupling of upper-level westerly winds with the easterly(southwesterly)boundary-layer winds facilitates expansion(eastward propagation)of the convective line,causing west-east-oriented heavy OWSR near the coast of YJ.In a word,this study reveals refined properties of OWSR initiation and development in the anticyclone synoptic situation,which may help improve the forecast skill of OWSR during the pre-summer rainy season in South China.