Abstract
BackgroundRepetitive transcranial magnetic stimulation (rTMS) has been employed for motor function rehabilitation for stroke patients, but its effects on post-stroke cognitive impairment (PSCI) remains controversial.ObjectiveTo identify the effects of rTMS intervention on PSCI patients and its potential neural correlates to behavioral improvements.MethodsWe recruited 34 PSCI patients for 20 sessions of 10 Hz rTMS or no-stim control treatments over the left dorsal lateral prefrontal cortex (DLPFC). Cognitive function was evaluated with the Montreal Cognitive Assessment Scale, Victoria Stroop Test, Rivermead Behavior Memory Test, and Activities of Daily Living (ADL) assessed with the Modified Barthel Index. 14 patients received functional MRI scan, a useful non-invasive technique of determining how structurally segregated and functionally specialized brain areas were interconnected, which was reflected by blood oxygenation level–dependent signals. The amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) were applied as the analytical approaches, which were used to measure the resting-state brain activity and functional connection.ResultsrTMS improved cognitive functions and ADLs for PSCI patients relative to patients who received no-stim control treatment. The cognitive improvements correlated to increased ALFF of the left medial prefrontal cortex, and increased FC of right medial prefrontal cortex and right ventral anterior cingulate cortex.Conclusion10 Hz rTMS at DLPFC could improve cognitive function and quality of life for PSCI patients, which is associated with an altered frontal cortical activity.Clinical RegistrationChinese Clinical Trial Registry, ChiCTR-IPR-17011908, http://www.chictr.org.cn/index.aspx.
Highlights
Post-stroke cognitive impairment (PSCI) impairs quality of life in stroke patients
Cognitive function was evaluated with the Montreal Cognitive Assessment Scale, Victoria Stroop Test, Rivermead Behavior Memory Test, and Activities of Daily Living (ADL) assessed with the Modified Barthel Index. 14 patients received functional MRI scan, a useful non-invasive technique of determining how structurally segregated and functionally specialized brain areas were interconnected, which was reflected by blood oxygenation level–dependent signals
The cognitive improvements correlated to increased amplitude of low-frequency fluctuation (ALFF) of the left medial prefrontal cortex, and increased functional connectivity (FC) of right medial prefrontal cortex and right ventral anterior cingulate cortex
Summary
Post-stroke cognitive impairment (PSCI) impairs quality of life in stroke patients. One-third of all stroke patients have varying levels of cognitive impairment and 7% post-stroke patients develop dementia within 1 year (Leys et al, 2005; Sachdev et al, 2006). With the development of the study of the brain network, cognitive impairments cannot be completely explained by the location after stroke but can be attributed to impairment of brain regions remote to the lesions. For these remote effects, it can be explained that the disruption of neuronal input is vital to the function of that remote brain region or of a certain network (Tuladhar et al, 2013). Previous studies have applied the rsfMRI technique, which suggested that the patients with PSCI have less functional connectivity within the brain networks (Ding et al, 2014; Dacosta-Aguayo et al, 2015). Repetitive transcranial magnetic stimulation (rTMS) has been employed for motor function rehabilitation for stroke patients, but its effects on post-stroke cognitive impairment (PSCI) remains controversial
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
