Observation On The Effects Of 5Hz And 10Hz Repeatitive Transcranial Magnetic Stimulation On Post-stroke Depression And Motor Disorder Patients

Objective The purpose of this study was to observe the therapeutic effect of high-frequency repetitive transcranial magnetic stimulation on depressive symptoms and motor function in patients with post-stroke depression,and to compare whether the two frequency stimulations of 5 Hz and 10 Hz have different effects on post-stroke depression and dyskinesia.Methods First,we randomly divided 42 eligible post-stroke depression patients into a 5Hz treatment group,a 10 Hz treatment group,and a sham stimulation group according to a random number table.All enrolled patients were given conventional rehabilitation treatment and antidepressant drugs.Routine rehabilitation treatment includes physical therapy,occupational therapy and acupuncture,etc.,once a day,5 days a week for a total of 3 weeks.The antidepressant is sertraline hydrochloride?Zoloft?,50 mg/day,once a day.In addition,the 5 Hz treatment group was given 100%intensity of 5 Hz repeated transcranial magnetic stimulation,the 10 Hz treatment group was given 100%intensity of10 Hz repeated transcranial magnetic stimulation,and the false stimulation group was given false stimulation.The stimulation site was the left dorsal lateral prefrontal cortex area.Each stimulation lasted 20 minutes,once a day,5 days a week for 3 weeks.Before treatment and after 3 weeks of treatment,42 patients were evaluated using HDRS-24,FMA,MBI and MEPL,and statistical methods were used to analyze based on the evaluation results.Among them,the main result is the HDRS-24 score,the secondary results are the response rate,remission rate,FMA score,MBI score and MEPL,and finally discuss based on the analysis results.Result Before treatment,the patients in the 5 Hz treatment group,the 10 Hz treatment group and the sham stimulation group compared the patients'age,course of disease,gender,and stroke type.The general data of the three groups of patients had no significant difference?P>0.05?,and had good uniformity.After 3 weeks of treatment,the HDRS-24score,FMA score,and MBI score of patients in the 5Hz treatment group and the 10Hz treatment group were significantly improved compared with that before treatment,and the MEPL was shortened compared with that before treatment.(5Hz treatment group:t_HDRS-24=14.38,t_FMA=6.43,t_MBI=6.01,t_MEPL=6.44;10Hz treatment group:t _HDRS-24=16.30,tFMA=15.33,t _MBI=9.51,t_MEPL=11.09,P<0.05)).The HDRS-24 scores of the5Hz treatment group and the 10Hz treatment group were improved compared with the sham stimulation group,and the MEPL was shorter than the sham stimulation group.The difference was statistically significant(F_HDRS-24=11.61,F_MEPL=5.59,P<0.05).The above results suggest that high-frequency repetitive transcranial magnetic stimulation can improve post-stroke depression and dyskinesia.Compared with the sham stimulation group,the FMA score and MBI score in the 5 Hz treatment and 10 Hz treatment groups were not statistically significant?P>0.05?.Compared with the 5 Hz treatment group,there was no statistically significant difference between the HDRS-24 score,FMA score,MBI score and MEPL in the 10 Hz treatment group?P>0.05?,this result suggests that 5Hz and 10 Hz have no significant difference in the improvement of depression and dyskinesia after stroke.The patients who met the response or remission criteria in the false stimulation group were 0.The remission rate and response rate in the 5 Hz treatment group were 7.7%and 38.5%,respectively.The remission rate and response rate in the 10Hz treatment group were 14.3%and 42.9%,respectively.After 3 weeks of treatment,the remission rate of the treatment group was not significantly improved compared with the sham stimulation group?P>0.05?,and the response rate of the treatment group was significantly improved?P<0.05?.The response rate and remission rate of patients in the10 Hz treatment group were not significantly improved compared with the 5 Hz treatment group?P>0.05?.Conclusion High frequency rTMS can help alleviate depression of PSD and improve limb exercise ability,but compared with the two High frequency rTMS of 5Hz and 10Hz,there is no obvious difference in improving depression and limb exercise ability.