TMS-Derived Neurophysiological Measures of Corticospinal Excitability, Intracortical Excitability, and Interhemispheric Interactions Associated With Post-Stroke Motor Recovery: A Systematic Review.
TMS measures such as motor-evoked potentials often changed alongside gains in movement or daily function, supporting their study as monitoring tools during stroke rehabilitation.
Pereira GS, da Silva ML, Baptista AF, de Araujo JE.
The European journal of neuroscience · Publication date: 2026-10-01
Added to site: 2026-10-06
DOI: 10.1111/ejn.70698
Published October 1, 2026. Added October 6, 2026.
- Modalities
- TMS/rTMS
- Clinical focus
- Stroke rehabilitation, Motor recovery biomarkers
- Population
- Adults with ischemic or hemorrhagic stroke
- Sample
- 16 randomized controlled trials; total participant denominator not reported in the abstract
- Intervention / method
- Studies from 2016 through July 10, 2026 using train-based rTMS or theta-burst stimulation and at least one TMS-derived neurophysiological measure
- Comparator
- Randomized active, sham or rehabilitation comparators varied across included trials
Clinician summary
MEP amplitude, MEP status and resting motor threshold were most common. Clinical motor-recovery evidence was rated moderate, while certainty for MEP and motor-threshold measures was low and intracortical or interhemispheric measures were low to very low.
How to interpret the findings
The review used narrative synthesis because stroke stage, stimulation dose, targets, rehabilitation, comparators, outcomes and TMS methods varied substantially. Most trials raised some risk-of-bias concerns, one was high risk, and only one stratified treatment response by baseline MEP status. These measures are not validated individual treatment-selection tests.
Equipment and disclosures
Equipment and acquisition methods varied across the included trials.
CAPES grant 88887.254059/2026-00 supported the review. The authors declare no conflicts of interest.
Related evidence
Compare findings from the same clinical area, including mixed results.
- Combined repetitive transcranial magnetic stimulation and mirror therapy for upper limb rehabilitation in stroke survivors: A systematic review and meta-analysis. · Positive with limitations
- EEG Biomarkers During Upper-Limb Action Observation Therapy for Stroke Rehabilitation: A Scoping Review. · Positive with limitations
Summary prepared with AI assistance. Source verification does not imply an independent replication or a clinician's endorsement. Read our review method.