Effects Of Intermittent Theta Burst Stimulation On Post-Stroke Cognitive Impairment:a Randomized Controlled Trial

Objective:Post-stroke cognitive impairment(PSCI)as one of the common sequelae after stroke,often leads to serious complications and affects the quality of life of patients.Therefore,it is a hot topic of rehabilitation ttreatment to seeking effective intervention therapies.Intermittent Theta Burst Stimulation(iTBS)as an emerging mode of repetitive Transcranial Magnetic Stimulation(rTMS),has shorter stimulation time and higher intensityis.The efficacy of iTBS in improving cognitive function on healthy subjects and Parkinson’s disease is clear,but there are still few studies on the efficacy of iTBS on post-stroke cognitive impairment(PSCI).The purpose of this study was to investigate the effect of iTBS on left Dorsolateral Prefrontal Cortex(DLPFC)combined with conventional cognitive training in improving PSCI.Methods:64 PSCI subjects admitted to the Department of Rehabilitation Medicine,Affiliated Hospital of North Sichuan Medical College were recruited and randomly divided into iTBS group(n=33)and control group(n=31)in a 1:1 ratio.iTBS group was treated with iTBS on left DLPFCcombined with conventional cognitive training,while the control group was treated with sham stimulation combined with conventional cognitive training,once a day,5 days a week,a total of 10 interventions.Outcomes were assessed before and after intervention,including Oxford Cognitive Screening Scale(OCS-P)and event-related potentials(ERPs)P300.Secondary outcome measures included the Simple Mental State Scale(MMSE)and the Montreal Cognitive Assessment(MoCA).Results:There was no difference in general clinical data between the two groups at baseline.After intervention,MoCA score and the latency of P300of the two groups showed statistically significant differences,while there was no significant difference between the two groups when compared with the control group.Compared with the control group,MMSE,memory and executive performance of OCS-P in the iTBS group significantly increased,and the amplitude of P300was significantly increased,with statistically significant differences between groups(P<0.05).No serious adverse reactions occurred during the whole experiment.Conclusion:iTBS can effectively and safely improve the overall cognitive impairment after stroke,especially memory and executive function.iTBS combined with conventional cognitive training may be an effective intervention for PSCI.