Comparative effectiveness of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on post-stroke spasticity: a narrative review Doi: https://doi.org/10.55522/jhpo.V3I4.0095

Abstract

In recent years, non-invasive brain stimulation techniques such as Repetitive Transcranial Magnetic Stimulation (rTMS) and Transcranial Direct Current Stimulation (tDCS) have emerged as promising interventions for improving stroke related comorbidities, particularly post-stroke spasticity. However, direct comparisons between these two modalities are limited, which makes clinical decision-making unclear. Therefore, this study aimed to compare the effectiveness of rTMS and tDCS in the management of post-stroke spasticity. The databases used were Google Scholar, MEDLINE, PubMed, and ResearchGate for studies published in the English language between years 2010-2025. A total of 21 studies were included in this review based on the selection criteria. We found that both interventions are effective in reducing spasticity, more importantly when supplemented by conventional physiotherapy and rehabilitation methods. Relative comparison suggested that rTMS showed slightly greater clinical improvement in spasticity. In conclusion, both rTMS and tDCS are effective treatments for post-stroke spasticity, However, rTMS may offer a more reliable reduction in spasticity than tDCS, although further well-designed comparative research is required to determine the feasibility, optimal practice and long-term outcomes.