| Objective:To analyze the effects of repetitive transcranial magnetic stimulation at different frequencies to improve cognitive dysfunction in stroke patients.Methods: From December 2017 to May 2018,60 patients with post-stroke cognitive dysfunction admitted to the rehabilitation department of the People’s Hospital of the Autonomous Region were randomly divided into 4 groups as control group,low frequency group,high frequency group and combined group.15 patients in each group.The control group was given risk factors control +cognitive drugs + rehabilitation training.On the basis of the control group,low frequency group was given1 Hz low frequency transcranial magnetic stimulation in the dorsal lateral prefrontal cortex in healthy side of the brain,high frequency group was given10 Hz high frequency transcranial magnetic stimulationin the dorsal lateral prefrontal cortex in affected side of the brain,the combined group was given high and low frequency bilateral stimulation,treatment for two weeks.before and after treatment,the cognitive function of the four groups of patients were performed neuropsychological assessments scales and related electrophysiological assessment like MMSE,MoCA,P300,using modified Barthel index to assess daily living ability.The improvement of cognitive function and daily living ability after treatment in 4 groups of patients was compared.Results: General comparison: There was no statistically significant difference between the general data of the four groups of patients and the indicators before treatment,that is,the data of each group were comparable.Comparison within the group:MMSE and MoCA comparison,the four groups of patients improved after treatment compared with before treatment,and the difference was statistically significant(P<0.05).MBI comparison,except for the high-frequency group,the remaining three groups were improved after treatment compared with before treatment,and the difference was statistically significant(P<0.05).P300 latency and amplitude comparison,Patients in the high-frequency group and the combined group after treatment,the P300 latency shortened and the amplitude of P300 prolonged.and the difference was statistically significant(P<0.05).Comparison between groups: MMSE,MoCA scores in the control group,low frequency group,high frequency group,combined group have no significant difference(P>0.05).The MBI comparison,the combined group has improved than the control group and high frequency group,and the difference was statistically significant(P<0.05).P300 latency comparison,the latency of P300 in the combined group has significantly shortened than the control group,and the difference was statistically significant(P<0.05).P300 amplitude comparison,the P300 amplitude of the combined group was significantly longer than that of the other three groups,and the difference was statistically significant(P<0.05).Comparison of differences between differences: MMSE comparison,rTMS groups improved compared with the control group,and in witch the combined group improved than the low frequency group,the difference was statistically significant(P<0.05).MoCA comparison,the rTMS groups improved compared with the control group,and the difference was statistically significant(P<0.05).The MBI comparison,the combined group has improved than the other three groups(P<0.05).The comparison of P300 latency,the latency of P300 in the combined group was significantly shorter than that in the control group and the low frequency group,and the difference was statistically significant(P<0.05).The comparison of P300 amplitude,the amplitude of P300 in the combined group was significantly longer than that in the other three groups,and the difference was statistically significant(P<0.05).Conclusion:Low-frequency transcranial magnetic stimulation and high-frequency transcranial magnetic stimulation can improve the cognitive dysfunction of stroke patients to a certain extent,and the combined application effect is better. |
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