Mirror neuron training improves the effectiveness of transcranial magnetic stimulation in treating vascular cognitive impairment

Abstract

Objective To explore the effect of high-frequency, repeated transcranial magnetic stimulation (rTMS) together with mirror neuron training on the cognition of persons with vascular cognitive impairment but without dementia (VCIND). Methods Thirty-three persons with VCIND were randomly divided into an rTMS+ MNS group (n=17) and an rTMS group (n=16) using a random number table. Both groups were given conventional rehabilitation training and rTMS over the left dorsolateral prefrontal cortex at 10 Hz, 2000 pulses per day at their individual motor thresholds on weekdays for 4 weeks using a CCY- I stimulator. The rTMS+ MNS group was additionally given mirror neuron training. The Montreal cognitive assessment (MoCA), the mini-mental state examination (MMSE) and the modified Barthel Index (MBI) were administered before and after the treatment. The P300 latency and amplitude of both groups were also measured. Results Before the treatment, no significant differences were found in any of the measurements. After the treatment, the average MoCA, MMSE and MBI scores had increased significantly in both groups, with those of the rTMS+ MNS group increasing significantly more than those of the rTMS group. After the treatment, the average P300 latency and amplitude of both groups were also significantly better than before the treatment. Compared with the rTMS group, the average P300 latency of the rTMS+ MNS group was significantly shorter, while the average amplitude was significantly greater. Conclusion Mirror neuron training combined with rTMS is more effective than rTMS alone in improving the cognition and ADL performance of VCIND patients. It is worth applying in clinical practice. Key words: Vascular cognitive impairment; Transcranial magnetic stimulation; Mirror neuron training