A randomized controlled study on intermittent theta pulse stimulation for improving cognitive impairment after stroke

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Neurology

Background:

• Stroke is a leading cause of long-term disability, often resulting in cognitive deficits and reduced quality of life.
• Current rehabilitation strategies have limitations in fully restoring cognitive function post-stroke.
• Identifying effective interventions to promote neuroplasticity and recovery is crucial for post-stroke care.

Purpose of the Study:

• To evaluate the efficacy of intermittent theta-burst stimulation (iTBS) in improving cognitive function and quality of life in subacute stroke patients.
• To investigate the underlying neurobiological mechanisms, including changes in neurotrophic and inflammatory markers, associated with iTBS treatment.
• To assess the safety and effectiveness of iTBS as an adjunctive therapy for stroke recovery.

Main Methods:

• A randomized controlled trial involving 80 subacute stroke patients with cognitive deficits.
• Patients were assigned to receive either conventional treatment plus sham stimulation (control) or conventional treatment plus iTBS over the left dorsolateral prefrontal cortex for 4 weeks (experimental).
• Cognitive function (MMSE, MoCA, TMT) and quality of life (SS-QOL) were assessed, along with serum levels of BDNF, TNF-α, and IL-6.

Main Results:

• The iTBS group showed significantly greater improvements in MMSE, MoCA, and SS-QOL scores compared to the control group.
• iTBS treatment led to a greater reduction in TMT completion time, indicating improved executive function.
• Biochemically, the iTBS group exhibited increased serum BDNF and decreased levels of TNF-α and IL-6, with BDNF levels positively correlating with cognitive improvements.

Conclusions:

• iTBS is a safe and effective intervention for enhancing cognitive recovery and quality of life in post-stroke patients.
• The therapeutic benefits of iTBS are linked to the modulation of neuroplasticity and inflammatory pathways, specifically via BDNF upregulation and neuroinflammation attenuation.
• These findings suggest iTBS as a promising non-invasive brain stimulation technique for stroke rehabilitation, warranting further mechanistic research.