| Objective To analyze the therapeutic effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on the left dorsolateral prefrontal cortex(DLPFC)on post-stroke cognitive impairment(PSCI)in right-handed patients,and to provide clinical reference for the ideal treatment of PSCI by rTMS.Methods Thirty-two patients with PSCI were randomly divided into control group(n= 14)and rTMS group(n = 18).Patients in the control group were treated with conventional drugs for cerebrovascular diseases and cognitive rehabilitation training.The rTMS group was treated with rTMS on the basis of the control group.The stimulation site was the left DLPFC,the stimulation frequency was 10 Hz,and the stimulation intensity was 80 % resting motor threshold(RMT).Both groups were treated once a day,5 times a week for 2 weeks.Before and after 2 weeks of treatment,the cognitive level of all PSCI patients was evaluated by Montreal Cognitive Assessment-Base Version(Mo CA-B)and Mini-Mental State Examination(MMSE).The activities of daily living were assessed by modified Barthel index(MBI).Anxiety and depression were assessed by Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD).Serum high-sensitivity CRP(hs-CRP)concentration was measured to evaluate the effect of rTMS on inflammatory response-related indicators.The evaluation results of all the above items were compared before and after treatment and between the two groups after treatment.When P < 0.05,the difference was statistically significant.Results 1.There was no significant difference in general clinical data(age,gender,course of disease,risk factors,years of education,nature of stroke,side of stroke and location of stroke)between the two groups before treatment(P > 0.05).2.MMSE scale score results :Before treatment,there was no statistical difference between the rTMS group and the control group(P > 0.05).After treatment,the rTMS group and the control group were higher than before treatment,and the rTMS group was higher than the control group.The difference was significant(P < 0.05).3.Mo CA-B scale score results : Before treatment,there was no statistical difference between the rTMS group and the control group(P > 0.05).After treatment,the rTMS group and the control group were higher than before treatment,and the rTMS group was higher than the control group,the difference was significant(P < 0.05).4.Mo CA-B sub-project score results : Before treatment,there was no statistical difference between the rTMS group and the control group in each cognitive field(P > 0.05).After treatment,there was only statistical difference in the improvement of orientation and calculation between the two groups(P < 0.05),and there was no statistical difference in the improvement of other cognitive fields.5.HAMA,HAMD scale score results : Before treatment,there was no statistical difference between the rTMS group and the control group(P > 0.05).After treatment,the rTMS group and the control group were higher than before treatment,and the rTMS group was higher than the control group,the difference was significant(P < 0.05).6.MBI scale score results : Before treatment,there was no statistical difference between the rTMS group and the control group(P > 0.05).After treatment,the rTMS group and the control group were higher than before treatment,and the change range of the rTMS group was higher than that of the control group.The difference was significant(P < 0.05).7.There was no significant difference in serum hs-CRP concentration between rTMS and control group before and after treatment(P > 0.05).Conclusion 1.The left high-frequency rTMS treatment of right-handed PSCI patients can improve the overall cognitive level,and the improvement effect in the field of orientation and computing power is more significant than other cognitive fields,and the safety is good.2.The left high-frequency rTMS can improve the cognitive function of PSCI patients,enhance the ability of daily living,and relieve anxiety and depression.3.Left high-frequency rTMS had no measurable effect on serum CRP concentration. |
