Analysis Of The Effect Of Repeated Transcranial Magnetic Stimulation On Patients With Post-stroke Depression And Its Effect On Serum BDNF And IL-23 Levels

BackgroundPost-stroke depression(PSD)is more common complications on acute cerebrovascular disease.PSD severely hinders the recovery of stroke Patients’Physical functions,affect their daily life and work,and also affect their families and society as a whole Increased a lot of economic and Psychological burden.At present,the mainstream treatment method for PSD is still drug therapy,but it is widely used due to many adverse drug reactions and poor patient compliance.Repetitive Transcranial Magnetic Stimulation(r TMS),as an emerging non-drug therapy,has been proved by clinical studies to be effective in the treatment of PSD,it has the traits of non-invasive,painless,accurate positioning,and relatively safe.Objective10Hz Repetitive Transcranial Magnetic Stimulation(r TMS)Clinical efficacy in the treatment on Post-Stroke Patients.Compare and Analyze the differences in HAMD-17,PSQI,MMSE scores before and after r TMS treatment,then analyze the effect of r TMS on serum BDNF and IL-23 levels.MethodsA total of 58 patients with PSD who met the eligibility criteria were selected from the neurology ward and outpatient department of the First Affiliated Hospital of Xinxiang Medical University from December 2018 to December 2020.The random number table method was used to separate the enrolled study subjects into treatment groups(Do-PSD group,n=29)and Control Group(Control group,n=29),Control Group received conventional PSD treatment,but Do-PSD group received high-frequency 10Hz r TMS in the dorsolateral left prefrontal lobe on the basis of the Control group treatment.Treatment,50 pulses per sequence,sequence interval 20 s,30 sequences each time,1 time/day,20 min each time,20 days is set as a treatment cycle.Peripheral venous blood was collected on day of admission and on the 21st day of treatment.The levels of serum interleukin-23 and BDNF were detected by ELISA,and the differences in HAMD-17,PSQI,and MMSE scores before and after r TMS treatment were compared and analyzed.The evaluation criteria for the improvement of depression symptoms were based on the USPSTF 2016version.Analyze the changes of serum IL-23,BDNF levels and adverse reaction rates.SPSS 24.0 statistical software was used for statistical analysis of data results.Results1.Comparison Baseline Data:Compare Do-PSD Group with the Control Group.Groups are not significant different in age,gender,history of hypertension,history of diabetes,fasting blood sugar,homocysteine,cholesterol,triglycerides,high-low-density lipids.Result of general characteristics such as protein level,lesion occurrence location and related scale evaluation scores(P>0.05);2.Comparison of HAMD-17 depression score,PSQI,and MMSE score:Continuous treatment with 10 Hz r TMS,The scores of HAMD-17?PSQI were lower than before treatment,and the total MMSE scores were higher than before treatment,and there were significant differences between those two groups before and after treatment(P<0.05);After treatment,comparing with the Control group,the HAMD-17 depression score and PSQI sleep score in the Do-PSD group were decreased significantly,and the MMSE score was significantly increased,and the differences were statistically significant(P<0.05).3.IL-23 and BDNF concentration changes and index correlation test:Reccepting 20days of continuous treatment,the IL-23 detection value of the two groups of patients was significantly lower than that before treatment,and the BDNF detection value was significantly higher than that before treatment.The results were statistically significantly different(P<0.05);compared with the Control group,Do-PSD After treatment,the concentration of IL-23 was significantly reduced and the concentration of BDNF was significantly increased,with a significant difference(P<0.05).4.Effective Rate:Reccepting experimental period,total clinical effective rate in the Do-PSD group was 89.66%,however in Do-PSD group is 62.07%in Control group.Results are statistically differented(P=0.002<0.01).5.Comparison of the incidence of adverse reactions:During the experimental observation period,for Do-PSD group,the total incidence of adverse reactions was 2(6.89%)cases,and the control group was 1(3.44%)case.The chi-square test value was?~2=3.000,P>0.05,There was no statistical difference between the two.ConclusionHigh frequency r TMS has a definite clinical effect on depressive symptoms of PSD patients,has a significant effect on depressive mood,social cognitive function,family adaptability,and effectively improves their sleep quality.It has good safety,which may be related to its regulation of IL-23/BDNF related factor expression and delay the body’s inflammatory response.