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

• Published in: Journal of integrative neuroscience Vol. 23; no. 8; p. 161
• Main Authors: Xu, Bingshan, Lin, Chunrong, Wang, Yiwen, Wang, Hong, Liu, Yao, Wang, Xiaojun
• Format: Journal Article
• Language: English
• Published: Singapore IMR Press 23.08.2024
• Subjects: Aged; Brain-Derived Neurotrophic Factor - blood; Brain-Derived Neurotrophic Factor - metabolism; Cognitive Dysfunction - etiology; Cognitive Dysfunction - physiopathology; Cognitive Dysfunction - therapy; Dorsolateral Prefrontal Cortex; dual-target; Female; Humans; Male; Middle Aged; Motor Cortex - physiopathology; post-stroke cognitive impairment; primary motor cortex; repetitive transcranial magnetic stimulation; Stroke - complications; Stroke - therapy; Stroke Rehabilitation - methods; Transcranial Magnetic Stimulation; Vascular Endothelial Growth Factor A - blood; Vascular Endothelial Growth Factor A - metabolism; dual-target; post-stroke cognitive impairment; dorsolateral prefrontal cortex; primary motor cortex; repetitive transcranial magnetic stimulation
• ISSN: 0219-6352
• DOI: 10.31083/j.jin2308161

The clinical application of 10 Hz repetitive transcranil magnetic stimulation (rTMS) remains limited despite its demonstrated effectiveness in enhancing cortical excitability and improving cognitive function. The present study used a novel stimulus target [left dorsolateral prefrontal cortex + primary motor cortex] to facilitate the enhancement of cognitive function through the bidirectional promotion of cognitive and motor functions; Methods: Post-stroke cognitive impairment patients ( = 48) were randomly assigned to receive either dual-target, single-target, or sham rTMS for 4 weeks. Before and after 4 weeks of treatment, participants were asked to complete the Montreal Cognitive Assessment (MoCA) test, the Modified Barthel Index (MBI), the Trail-making Test (TMT), and the Digital Span Test (DST). In addition, the levels of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) in serum were also measured. After adjusting for pre-intervention (baseline) MoCA scores, the post-intervention MoCA scores varied significantly. After post-hoc analysis, differences existed between the post-treatment scores of the dual-target rTMS group and the sham rTMS group (the experimental group scores were significantly higher), and between those of the dual-target rTMS group and the single-target rTMS group (the dual-target rTMS scores were significantly higher). The serum VEGF levels of the dual-target rTMS group were significantly higher those that of the sham rTMS group. The present study presented data showing that a dual-target rTMS therapy is effective for Post-stroke cognitive impairment (PSCI). The stimulation exhibited remarkable efficacy, suggesting that dual-target stimulation (left dorsolateral prefrontal cortex+motor cortex (L-DLPFC+M1)) holds promise as a potential target for TMS therapy in individuals with cognitive impairment after stroke. No: ChiCTR220066184. Registered 26 November, 2022, https://www.chictr.org.cn.