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Updated: Sep 3, 2026
Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
Combined hyperbaric oxygen and repetitive transcranial magnetic stimulation for vascular cognitive impairment: a
Yixiu Lin1, Xinxin Chen2, Dan Li1,3
1Department of Rehabilitation Medicine, Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background:
Effective rehabilitation strategies for vascular cognitive impairment (VCI) still remain limited. This study was aimed to explore the clinical efficacy and related mechanisms of hyperbaric oxygen therapy (HBOT) combined with repetitive transcranial magnetic stimulation (rTMS) for VCI.
Methods:
72 participants were recruited and randomly assigned to the control, HBOT, rTMS, and Combined (HBOT combined with rTMS) groups. The primary outcome measures were the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE), while the secondary outcome measures comprised the Modified Barthel Index (MBI), the Self-rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS). The concentration of oxygenated hemoglobin (HbO2) in the cerebral cortex was measured by near-infrared spectroscopy (fNIRS). These indicators were measured at the baseline (T1) and 3 weeks after the intervention (T2).
Results:
After treatment, the significant improvements in MoCA, MMSE, and MBI scores, and the reductions in SAS and SDS scores were observed across all groups (all p < 0.05). Regarding the primary outcomes, the combined group showed significantly greater improvement in MoCA and MMSE scores compared to each of the other three groups (p < all 0.05). For the secondary outcomes, the combined treatment group showed significantly greater improvement in MBI scores only than the control group (p < 0.05), and no significant inter-group differences were observed in the changes of SAS or SDS scores before and after treatment (all p > 0.05). Additionally, fNIRS analysis following FDR correction showed that CH9 and CH45 channels had statistically significant differences in HbO2 after treatment (all p < 0.05), though a sensitivity analysis suggested these findings may be partially influenced by physiological noise.
Conclusion:
Combined HBOT and rTMS therapy demonstrates superior efficacy in improving cognitive function which may be mediated by the primary somatosensory cortex and primary motor cortex of the brain. However, the combined regimen did not yield greater improvement in daily function or mood. Combined HBOT + rTMS is a promising cognitive rehabilitation strategy in the treatment of VCI.
Clinical Trial Registration:
https://www.chictr.org.cn/showproj.html?proj=190934, Identifier ChiCTR2300068242.
