HIF1A and Stroke: Thus, it appears that HIF-1α is a key driving force of the various mechanistic pathways activated by rTMS treatment, as depicted in Figure 10C. HIF-1α is known to be expressed in the peri-infarct region after stroke, although whether this is always beneficial or sometimes maladaptive is disputed 101 In this study, however, the pathways activated by HIF-1α clearly worked synergistically to promote powerful recovery mechanisms.