Effect Of Repetitive Transcranial Magnetic Stimulation On Post-stroke Cognitive Impairment

Background and ObjectiveWith the development of modern society, the incidence of stroke in our population increased year by year, seriously affecting people's lives and health. After stroke, the patients is often associated with neurological disorders, such as hemiplegia, aphasia, dysphagia and so on. Post-stroke cognitive impairment(PSCI), one of the common complications of stroke patients, refers to the acute cerebrovascular types and degree of cognitive impairment caused by the disease and is an important part of vascular cognitive impairment. The prognosis of most PSCI patients is not ideal, which is even a heavy burden to the family. Drug therapy, acupuncture, rehabilitation training on PSCI patients still cannot obtain satisfactory results. Currently, repetitive transcranial magnetic stimulation(rTMS) as a safe, non-invasive and acceptable treatment to the patients, widely used in clinical practice, studies have suggested that rTMS improved schizophrenia, Parkinson's disease, depression disorder, organic brain diseases significantly. But at this stage, rTMS in clinical study for the treatment of PSCI is relatively less. In this study,we choose patients with PSCI as research subjects to explore the treatment effect of rTMS. MethodsThe research choosed 40 patients in accordance with the standards above who had been diagnosed as cognitive dysfunction after stroke were randomly divided into the true stimulation group(n=20) and pseudo-stimulation group(n=20).Two groups were given the same cognitive rehabilitation. True stimulation group received real rTMS stimulation therapy, stimulation area: left dorsolateral prefrontal cortex(DLPFC), with the frequency of 10 Hz, stimulus intensity was 80% motor threshold(MT), stimulation time: 2s, interval: 20s, treatment time: 20 min. The pseudo-stimulation group stimulated the patient's skull with a coil perpendicular to the surface, only resulting in the vibration and sound, but did not produce a therapeutic effect. All the treatments above lasted for 8 weeks(once a day, 5 days a week). The cognitive function of the two groups were measured before and after 8 weeks of treatment, using the Montreal Cognitive Assessment(MoCA), Rivermead Behaviour Memory Test(RBMT), Modified Barthel Index(MBI) to assess the recovery of cognitive function in PSCI patients and daily living. ResultsBefore treatment, MoCA score, RBMT score and MBI score of patients in two groups were not significantly different(P>0.05). After 8 weeks of treatment, MoCA score, RBMT score and MBI score of patients in two groups were significantly increased than those of before treatment(P<0.05). While compared with pseudo-stimulation group, three kinds of scores in true stimulation group increased more significantly(P <0.05). ConclusionrTMS can improve cognitive function of PSCI patients, such as memory, attention, executive function and so on. It can also improve the patient's activity of daily living. It is a relatively effective therapy and worthy of promotion in clinical applications.