Best Neurosurgeon in India- Dr. Paresh Kishorchandra Doshi

Best Stroke Rehabilitation Hospital in Mumbai

RNR Medicine at Jaslok Hospital is recognized as one of the best stroke rehabilitation hospitals in Mumbai, which offers non-invasive neuromodulation treatment for psychiatric diseases and chronic pain in neurological conditions. RNR Medicine uses cutting-edge technology and evidence-based protocols to help stroke patients overcome their symptoms and improve their quality of life. RNR Medicine is a unique and innovative department in India, with a team of experts and specialists in the field of restorative medicine.

Stroke is an acute syndrome characterized by clinical signs of focal (or global) disturbance of cerebral function. The resulting reduction in arm and leg function often leads to substantial disability, impacting daily living and placing a significant burden on affected individuals and their families. Dedicated research is underway globally to find innovative methods to alleviate the suffering and disability experienced by stroke patients. One such promising approach is Transcranial Magnetic Stimulation (TMS), a noninvasive and painless method that effectively modulates cortical excitability. Recent studies have demonstrated the potential of TMS in improving outcomes for individuals recovering from stroke-related disabilities.

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Candidacy for TMS in Stroke Disabilities

Stroke can result in lifelong disabling conditions such as paralysis, weakness, or numbness. Individuals experiencing these challenges are potential candidates for Transcranial Magnetic Stimulation (TMS). Here are some specific conditions that make patients suitable candidates for TMS:

  • Arm Paralysis: Individuals facing challenges in writing, holding, and gripping objects due to arm paralysis can benefit from TMS.
  • Leg Weakness: TMS is beneficial for patients with leg weakness, addressing issues related to impaired walking, imbalance while walking or standing.
  • Swallowing/Chewing/Drinking Difficulties: Patients experiencing difficulty in swallowing, chewing, or drinking as a result of stroke-related complications are potential candidates for TMS.

Additionally, TMS is a viable option for individuals with various medical conditions, including pregnancy, hypertension, diabetes, thyroid disorders, kidney diseases, and heart diseases. The use of common medical devices such as stents, pacemakers, coils, and orthopedic implants, which are usually MRI-compatible, does not typically interfere with TMS procedures. This makes TMS a versatile and inclusive treatment option for a broad range of patients recovering from the aftermath of a stroke.

 

Present Literature

The extensive research on Transcranial Magnetic Stimulation (TMS) since the 1980s has yielded a wealth of literature, particularly in peer-reviewed journals, showcasing positive outcomes with minimal adverse effects. Noteworthy studies focusing on TMS applications for patients with arm or leg weakness post-stroke include:

 

Italian Study on Lower Limb Motor Impairments:

  • This study conducted in Italy involved chronic stroke patients with lower limb motor impairments.
  • Patients underwent a 3-week course of high-frequency deep TMS.
  • The results indicated a significant and lasting improvement in lower limb functions, extending at least 1 month after the completion of the treatment.

 

Efficacy Study on Upper Limb Motor Difficulties:

  • Another study investigated the efficacy of 11 TMS sessions in 20 patients facing upper limb motor difficulties post-stroke.
  • Patients receiving TMS exhibited a remarkable 70% improvement in upper limb movement compared to the sham group, which did not undergo the treatment.

These studies underscore the positive impact of TMS in enhancing motor functions and offer promising insights into its effectiveness for individuals recovering from stroke-related motor impairments.

 

Method

  • Transcranial Magnetic Stimulation (TMS) is a non-invasive method of Neuromodulation designed to enhance motor functions. The procedure involves low-energy magnetic stimulation targeted at specific brain sites through the skull. This stimulation is delivered using a specially designed coil incorporated into a helmet.

The procedural steps are as follows:

Patient Arrival and History:

  • Upon arrival, the patient’s detailed history is taken by a nurse who updates the doctor.
  • The doctor then discusses the most suitable protocol with the patient, outlining the duration of each session, the frequency of sessions per week, and the total number of sessions.

 

Protocol Confirmation and Computer Input:

  • Once the protocol is confirmed, it is input into the computer for further reference.

 

Motor Threshold (MT) Determination:

  • The patient undergoes an evaluation to determine the Motor Threshold (MT) by receiving stimulation through the helmet.
  • TMS Administration:
  • Based on the pre-designed protocols, TMS is administered to the patient.

 

Number of Sessions and Duration:

  • For stroke patients, about 16 sessions are typically recommended over a 4-week period.
  • Each session lasts approximately 15-20 minutes.

 

No Sedation or Anesthesia Required:

  • The procedure does not necessitate sedation or anesthesia.
  • Fasting is not required before the procedure.
  • This streamlined process ensures that stroke patients receive TMS treatment with minimal inconvenience and discomfort, promoting a non-invasive and patient-friendly experience.

 

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Why Should You Choose Jaslok Hospital for TMS?

Jaslok Hospital & Research Centre stands as one of the oldest tertiary care, multi-specialty Trust hospitals in the country, recognized for its commitment to excellence in healthcare. The hospital actively engages in ongoing research activities across various fields, collaborating with institutions in India and abroad.

The “Restorative and Regenerative Medicine” department at Jaslok Hospital comprises seasoned consultants with more than 20 years of experience, dedicated to providing advanced and innovative medical solutions. To enhance its capabilities, the department has acquired state-of-the-art technology and equipment from the internationally reputed “Brainsway” company. Notably, the department employs advanced H1-7 coils, a technological leap beyond conventional coils. These specialized coils facilitate noninvasive deep Transcranial Magnetic Stimulation (TMS) with precision, ensuring optimal results for patients.

FDA and CE clearances further attest to the department’s commitment to quality and safety. Unlike conventional TMS, which is limited to specific target sites, the Deep TMS employed by Jaslok Hospital’s Restorative and Regenerative Medicine department can reach various target sites, including the insula and cingulate gyrus. This integration of cutting-edge technology and experienced medical professionals underscores Jaslok Hospital’s dedication to providing state-of-the-art healthcare solutions for various neurological and psychiatric conditions.

 

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