Effect Of Re-Transcranial Magnetic Stimulation On Cognitive Function In Patients With Stable COPD

Objective:The aim of this study is to investigate the effects of re-transcranial magnetic stimulation（r TMS）on cognitive function in stable COPD patients by detecting the serum expression levels of neuron-specific enolase（NSE）,growth differentiation factor 11（GDF11）,central neurospecific protein（S100β）and the changes of electroencephalpgram.And analyze the correlation between the changes of serum protein,EEG with cognitive function.Methods:Forty-eight patients with stable COPD attending the Affiliated Hospital of Hangzhou Normal University from October 2020 to October 2022 were selected,including 24 patients in the stimulation group and 24 patients in the pseudo-stimulation group.All the people above were assessed the cognitive function by the Montreal Cognitive Assessment Scale（Mo CA）and the Simple Mental State Examination Scale（MMSE）.Enzyme-linked immunosorbent assay（ELISA）was used to detect the expression levels of serum NSE,GDF11,and S100β,electroencephalography to assess changes in cortical neuroexcitability,and pulmonary function to assess the severity of COPD patients’disease.Cognitive scale,serological indicators and electroencephalogram were re-evaluated to analyze the changes of cognitive function after r TMS treatment.Results:（1）General and clinical data:There was no statistical significance in gender,age,BMI,education years,total course of disease,lactic acid,Pa O2,Pa CO2,smoking index,FEV₁/FVC,and FEV₁%pred between the stimulation group with the pseudo-stimulus group（P>0.05）.There was no statistical significance in Mo CA scale and MMSE scale scores,serum protein factor NSE,S100β,and The differences in Mo CA scale and MMSE scale scores,serum protein factor NSE,S100β,GDF11expression levels,and EEG frontal and temporal area alpha wave energy values were not statistically significant between the two groups（P>0.05）.（2）Cognitive function score:Mo CA and MMSE scores increased after r TMS treatment,the difference was statistically significant（P<0.05）.（3）Serum indexes:Serum NSE and S100βwere decreased after r TMS treatment（P<0.05）,but GDF11 level was increased,the difference was statistically significant（P<0.05）.（4）Electroencephalogram（EEG）:The alpha power in the frontal and temporal regions of the patients increased after r TMS treatment,the difference was statistically significant（P<0.05）.（5）Correlation analysis:Mo CA scores were negatively correlated with serum NSE and S100βvalues（r=-0.731,r=-0.686,P<0.05）and positively correlated with serum GDF11 and alpha wave power（r=0.647,r=0.464,r=0.449,P<0.05）;MMSE scores were negatively correlated with serum NSE and S100βvalues（r=-0.517,r=-0.495,P<0.05）,and positive correlation with serum GDF11 and alpha wave energy values（r=0.345,r=0.383,r=0.363,P<0.05）.Conclusion:The occurrence of cognitive imparment in COPD patients may be related to expression levels of serum NSE,GDF11 and S100β.r TMS treatment can decrease the expression of NSE and S100β,increase the expression of GDF11,and improve cognitive function in COPD patients.