Repeated transcranial magnetic stimulation combined with Donepezil can improve the cognition of cognitively impaired stroke survivors

Abstract

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with donepezil on the cognition of persons with post-stroke cognitive impairment (PSCI) and their ability to perform activities of daily living (ADL). Methods A total of 106 PSCI patients were randomly divided into an observation group and a control group using a random number table. Those in the observation group received 10Hz rTMS (5 seconds on and 25 seconds off for 20 minutes daily) and donepezil daily, 5 days per week for 4 weeks, while those in the control group were provided with donepezil but only sham rTMS on the same schedule. Before and after 4 weeks of treatment, the Montreal cognitive assessment scale (MoCA), the Rivermead behavior memory test (RBMT) and the modified Barthel index (MBI) were used to evaluate the subjects′ cognitive functioning, memory capacity and ADL ability. The latency and amplitude of auditory event-related potential P300 were also assessed using a myoelectric evoked potential apparatus. Results After the treatment, improvement was observed in all the measurements of both groups. After the treatment, the average MoCA, RBMT and MBI scores, as well as the latency and amplitude of P300 in the observation group were all significantly better than among the control group. Conclusions rTMS can supplement donepezil′s ability to improve the cognition and ADL ability of persons with PSCI. Such therapy is worthy of clinical promotion and application. Key words: Stroke; Cognitive impairment; Transcranial magnetic stimulation; Donepezil