Using Dual-Target rTMS, Single-Target rTMS, or Sham rTMS on Post-Stroke Cognitive Impairment

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• Repetitive transcranial magnetic stimulation (rTMS) at 10 Hz shows potential for enhancing cognitive function.
• Clinical application of rTMS is limited, necessitating novel stimulation targets.
• A dual-target approach combining left dorsolateral prefrontal cortex (L-DLPFC) and primary motor cortex (M1) was investigated.

Purpose of the Study:

• To evaluate the efficacy of dual-target rTMS in patients with post-stroke cognitive impairment (PSCI).
• To compare the effects of dual-target rTMS, single-target rTMS, and sham rTMS on cognitive and motor functions.
• To assess changes in neurotrophic factors (BDNF, VEGF) following rTMS treatment.

Main Methods:

• 48 patients with PSCI were randomized into dual-target rTMS, single-target rTMS, or sham rTMS groups for 4 weeks.
• Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Trail-making Test (TMT), and Digital Span Test (DST).
• Motor function was evaluated using the Modified Barthel Index (MBI), and serum levels of BDNF and VEGF were measured.

Main Results:

• Dual-target rTMS significantly improved MoCA scores compared to sham and single-target rTMS.
• Significant differences in post-treatment MoCA scores were observed between the dual-target and sham groups, and between the dual-target and single-target groups.
• Serum vascular endothelial growth factor (VEGF) levels were significantly higher in the dual-target rTMS group compared to the sham group.

Conclusions:

• Dual-target rTMS (L-DLPFC+M1) is an effective therapy for post-stroke cognitive impairment.
• This novel stimulation strategy demonstrates significant efficacy in improving cognitive function.
• Dual-target rTMS holds promise as a therapeutic target for stroke-related cognitive deficits.