ObjectiveTo observe the therapeutic effects of deep transcranial magnetic stimulation (dTMS) and repetitive transcranial magnetic stimulation (rTMS) on upper and lower limb motor dysfunction in patients with basal ganglia infarction, and to preliminarily explore their underlying electrophysiological mechanisms.MethodsThirty patients with motor dysfunction secondary to basal ganglia infarction, hospitalized at the Affiliated Hospital of North Sichuan Medical College between October 2024 and December 2025, were enrolled in this study. All eligible participants were randomly assigned to one of three treatment groups: dTMS (n = 10), rTMS (n = 10), or sham stimulation (n = 10). All patients in the three groups received routine medical treatment and conventional rehabilitation training. On this basis, the dTMS group was treated with 10 Hz dTMS, the rTMS group with 10 Hz rTMS, and the sham stimulation group with sham stimulation, 5 sessions per week for 2 consecutive weeks. Before treatment, on the first day after treatment, and at 30 days after treatment, the Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), and Modified Barthel Index (MBI) were used to evaluate motor function of the affected side and activities of daily living. The resting motor threshold (rMT) and central motor conduction time (CMCT) of the affected hemisphere were measured simultaneously.ResultsThe baseline data among the three groups were comparable (all p > 0.05); After treatment, there was a statistically significant interaction between group and time in FMA-UE, FMA-LE, MBI, and BBS scores among the three groups (all p < 0.05); Compared with baseline, FMA-UE, FMA-LE, MBI, and BBS scores were significantly increased on the first day and at 30 days after treatment in all three groups (all p < 0.001); Compared with the sham stimulation group, the dTMS group exhibited higher FMA-UE, FMA-LE, MBI, and BBS scores on the first day and at 30 days after treatment (all p < 0.05); Compared with the rTMS group, the dTMS group showed no significant differences in FMA-UE and MBI scores on the first day after treatment (all p > 0.05), but higher FMA-LE and BBS scores (all p < 0.05), at 30 days after treatment, FMA-UE, FMA-LE, MBI, and BBS scores were all higher in the dTMS group (all p < 0.05). There was a statistically significant interaction between group and time in rMT and upper limb CMCT among the three groups after treatment (all p < 0.05); Compared with baseline, rMT and upper limb CMCT were significantly decreased on the first day and at 30 days after treatment in all three groups (all p < 0.001); Compared with the sham stimulation group, the dTMS group had lower rMT and upper limb CMCT on the first day and at 30 days after treatment (all p < 0.05); Compared with the rTMS group, the dTMS group showed lower rMT and upper limb CMCT on the first day after treatment (p < 0.05), at 30 days after treatment, rMT was lower (p < 0.05), while no significant difference was found in upper limb CMCT (p > 0.05).Conclusion(1) Both high-frequency dTMS and rTMS can improve upper limb motor dysfunction after basal ganglia cerebral infarction to some extent, and the therapeutic effect of dTMS lasts longer; (2) dTMS has a certain rehabilitative effect on lower limb motor and balance function; (3) The mechanisms underlying the improvement of motor dysfunction after basal ganglia cerebral infarction by high-frequency dTMS and rTMS may be associated with increased excitability of the affected cerebral cortex, enhanced function of the corticospinal tract pathway. In addition, dTMS can directly act on deeper and wider brain regions; (4) Both high-frequency dTMS and rTMS are safe.
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