Advances in Stroke Recovery Scientific Conference 2023 Abstracts.

Background: Rehabilitation is critical for reducing strokerelated disability and improving quality-of-life post-stroke. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique, shows a beneficial effect for motor recovery in a subgroup of stroke patients. The Canadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim) seeks to advance the use of neuromodulation techniques to improve post-stroke recovery through clinical trials and pre-clinical studies using standardized research protocols. Here, we review existing clinical trials of stroke recovery to identify demographic, clinical, and neurobiological factors that help to predict individual rTMS treatment response in stroke patients with motor deficits to develop research perspectives for pre-clinical and clinical studies. Methods: A literature search was performed in PubMed, using the Boolean search terms ‘stroke’, ‘repetitive transcranial magnetic stimulation’ and ‘motor’ for studies investigating the use of rTMS for motor recovery in stroke patients at any recovery phase. A total of 1,676 articles were screened by two blinded raters, with 26 papers identified for inclusion in this review. Results: Multiple possible factors associated with rTMS response were identified, including stroke location, cortical thickness, brain-derived neurotrophic factor (BDNF) genotype, initial stroke severity, and several imaging and clinical factors associated with a relatively preserved functional motor network of the ipsilesional hemisphere. Age, sex, and time post-stroke were generally not related to rTMS response. Factors associated with greater response were identified in studies of both excitatory ipsilesional and inhibitory contralesional rTMS. Heterogeneous study designs and contradictory data exemplify the need for greater protocol standardization. Conclusion: Clinical, brain structural and neurobiological factors have been identified as potential predictors for rTMS response in stroke patients with motor impairment. These factors can inform the design of future clinical trials, before being considered for optimization of individual rehabilitation therapy for stroke patients. Examining the association between balance confidence and balance performance in individuals with stroke: A cross-sectional study Eric Huynh1, Elise Wiley1, Sarah Park2, Brodie Sakakibara2, Ada Tang1 1McMaster University. 2University of British Columbia