Intermittent theta-burst stimulation for post-stroke cognitive impairment: a double-blind randomized controlled trial

Post-stroke cognitive impairment (PSCI) significantly affects patients' quality of life. Although standard repetitive transcranial magnetic stimulation (rTMS) has shown promising efficacy, the effectiveness of the newer, more time-efficient intermittent theta-burst stimulation (iTBS) remains to be validated.

Two groups of randomly assigned patients with PSCI received either four weeks of two 600-pulse iTBS treatment sessions with a 50-minute interval between sessions or sham stimulation. Cognitive function and activities of daily living were assessed before and after treatment using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Modified Barthel Index (MBI).

Sixty patients were enrolled, and 57 completed the study. Patients in the iTBS group demonstrated significantly higher MMSE scores, MoCA scores, and MBI scores compared to the sham stimulation group (p < 0.05for all). Only one patient experienced a headache during treatment, and no serious adverse events occurred.

Two blocks of iTBS therapy with 600 pulses each at 50-minute intervals demonstrated favorable therapeutic effects in patients with PSCI.