Focal Hand Dystonia: Individualized Intervention With Repeated Application of Repetitive Transcranial Magnetic Stimulation  Teresa Jacobson Kimberley, PhD, PT, Michael R. Borich, DPT, PhD, Rebekah L. Schmidt, BS, James R. Carey, PhD, PT, Bernadette Gillick, PhD, MSPT, PT  Archives of Physical Medicine and Rehabilitation  Volume 96, Issue 4, Pages S122-S128 (April 2015) DOI: 10.1016/j.apmr.2014.07.426 Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 1 Phase I mean CSP change score within session. Stimulation given at 90% and 110% of RMT are shown for the M1 and PMd. The largest mean change for both participants was 90% of RMT for the PMd. Archives of Physical Medicine and Rehabilitation 2015 96, S122-S128DOI: (10.1016/j.apmr.2014.07.426) Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 2 Phase II handwriting results. Mean axial pen pressure at baseline, each week of the intervention, and at 1-week follow-up. The 95% CI is established at baseline and represented by the short dashed line for (A) subject 1 (black) and the long dashed line for (B) subject 2 (gray). Square markers indicate nonsignificant difference from baseline; and diamond markers, significant difference from baseline. Archives of Physical Medicine and Rehabilitation 2015 96, S122-S128DOI: (10.1016/j.apmr.2014.07.426) Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 3 Phase II CSP length. The 95% CI is established at baseline and is represented by the short dashed line for subject 1 (black) and the long dashed line for subject 2 (gray). Square markers indicate nonsignificant difference from baseline; and diamond markers, significant difference from baseline. Archives of Physical Medicine and Rehabilitation 2015 96, S122-S128DOI: (10.1016/j.apmr.2014.07.426) Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 4 Phase II paired-pulse assessment: (A) short ICF (PP10/SP=PP10/SP = ratio of facilitation MEP associated with 10ms conditioning pulse, prior to test pulse divide by single pulse MEP response), and (B) SICI (PP3/SP = ratio of inhibited MEP associated with 3ms conditioning pulse prior to test pulse, divide by single pulse MEP response). The 95% CI is established at baseline and is represented by the short dashed line for subject 1 (black) and the long dashed line for subject 2 (gray). Square markers indicate nonsignificant difference from baseline; and diamond markers, significant difference from baseline. The shaded area represents abnormal responses for each test. The responses for subject 1 (black) lengthened (normalized) but did not achieve significance. The responses for subject 2 (gray) shortened. Abbreviation: SP, single pulse. Archives of Physical Medicine and Rehabilitation 2015 96, S122-S128DOI: (10.1016/j.apmr.2014.07.426) Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions