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ObjectiveTo explore the brain mechanism of repetitive transcranial magnetic stimulation (rTMS) on dysfunction after stroke using functional magnetic resonance imaging (fMRI). MethodsLiteratures about the functional magnetic resonance imaging study about repetitive transcranial magnetic stimulation for dysfunction after stroke were retrieved in PubMed, Web of Science, CNKI and Wanfang data from establishment to June 1st, 2021. The quality of the literature was evaluated with Physiotherapy Evidence Database (PEDro) scale. Literature screening, and data extraction were performed by two researchers. ResultsA total of 14 randomized controlled trials were finally enrolled. They were of high or very high quality. They mainly involved the therapeutic effect and imaging mechanisms of rTMS on dysfunction after stroke. ConclusionrTMS could change the excitability of the cerebral cortex and the effective connections between brain regions after stroke, promote the reorganization of brain function, and achieve the recovery of post-stroke dysfunction.
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ObjectiveTo investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on walking function of stroke patients at recovery stage. MethodsFrom January, 2021 to January, 2022, 60 stroke inpatients at recovery stage from Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine were randomly divided into group A (n = 20), group B (n = 20) and group C (n = 20). All the groups accepted conventional rehabilitation therapy and lower limb robot-assisted training, while group B accepted pseudo-rTMS, and group C accepted high-frequency rTMS, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Timed 'Up and Go' Test (TUGT) and gait analysis before and after treatment. ResultsThe score of FMA-LE, TUGT, pace, stride width, stride, double support phase time, affected side support phase time, affected side swing phase time, healthy side support phase time and healthy side swing phase time improved after treatment in all the groups (|t| > 5.990, P < 0.001), and all the indexes improved the most in group C (F > 3.210, P < 0.05), except double support phase time. ConclusionHigh-frequency rTMS could facilitate the recovery of lower limb function and walking of stroke patients at recovery stage.
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Abstract A patient with chronic brainstem CVA sequelae received one cycle of magnetic stimulation to treat her dysphagia and serendipitously obtained a minimal improvement in her axial movement. Two additional cycles gave her improved postural control and then distal movement, preceded by a display of ipsilateral and contralateral motor evoked potentials, respectively. Magnetic stimulation at 10 Hertz produces cortical disinhibition and reopens the critical neurodevelop ment periods. The ontogenic pattern of hemiplegia recovery in this patient may be explained by an increased and rejuvenated brain plasticity due to critical period reopening through cortical disinhibition. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2253).
Resumen Una paciente con secuelas crónicas de un ACV del tallo cerebral recibió un ciclo de estimulación magnética para el manejo de la disfagia y, por serendipia obtuvo mejoría leve del movimiento axial. Dos ciclos adicionales le permitieron mejoría del control postural y luego la aparición de movimiento distal, precedidos por la visualización de los potenciales evocados motores ipsilateral y contralateral, respectivamente. La estimulación magnética a 10 Hertz produce desinhibición cortical y reabre los periodos críticos del neurodesarrollo. Es posible, que el patrón ontogénico de recuperación de la hemiplejía en esta paciente se explique por el incremento y rejuvenecimiento de la plasticidad cerebral debido a la reapertura de los periodos críticos, por medio de la desinhibición cortical. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2253).
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Objective:To explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive behavioral therapies (CBT) on the cognitive function and alcohol craving in patients with alcohol dependence.Methods:From March 2019 to September 2021, a total of 150 patients with alcohol dependence were enrolled and randomly divided into rTMS treatment group (rTMS+ sham CBT, n=41), CBT treatment group (CBT+ sham rTMS, n=34), rTMS+ CBT treatment group( n=36) and control group (sham rTMS+ sham CBT, n=39). At baseline (before treatment), 2nd week, 8th week, 12th week and 24th week, alcohol dependence scale (ADS) was used to evaluate the degree of alcohol dependence, the obsessive compulsive drinking scale (OCDS) was used to assess patients' drinking craving, and Montreal cognitive assessment scale (MoCA) was used to assess the overall cognitive level of patients.SPSS 23.0 statistical software was used to compare the differences of ADS, OCDS and MoCA scale scores of the four groups by repeated measure ANOVA and simple effect analysis. Results:(1)The patients in the four groups were evaluated with ADS scale at baseline, 12th week and 24th week respectively.The interaction of group×time( F=1.279, P=0.279) and the main effect of group were not significant ( F=0.882, P=0.454), and the main effect of time was significant ( F=12.925, P<0.001) .Further simple effect analysis showed that the ADS score of rTMS+ CBT group was lower than that of baseline(14.48±5.70, 10.00±6.51) ( P=0.01) at 24th week.(2)Patients in the four groups were assessed with OCDs scale at baseline, 2nd week, 8th week, 12th week and 24th week, and the interaction of group×time was significant ( F=2.015, P=0.042). Further simple effect analysis showed that the OCDs scores of rTMS group and rTMS+ CBT group at each follow-up time node were lower than those at baseline period (all P<0.05). (3)Patients in the four groups were assessed with MoCA scale at baseline, 8th week, 12th week and 24th week, and the interaction of group×time was not significant ( F=1.660, P=0.106), and the main effect of group and the main effect of time were significant ( F=2.964, P=0.038; F=14.239, P<0.001). Further simple effect analysis showed that the score of MoCA scale in CBT group at the 24th week was higher than that at baseline (21.73±5.81, 24.60±3.98)( P=0.029), the score of MoCA scale in rTMS+ CBT group at the 24th week was higher than that at the 8th week (23.50±6.01, 25.95±2.87) ( P=0.006), and the score of MoCA scale in rTMS group at the 12th week was higher than that in control group (22.08±6.64, 26.64±2.46)( P=0.009). Conclusion:rTMS combined with CBT can be effective in improving alcohol craving and cognitive function in patients with alcohol dependence, and has a good long-term effect.
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Objective:To explore the effect of repetitive transcranial magnetic stimulation(rTMS) combined with cognitive behavioral therapy for insomnia(CBT-I)for menopausal women with insomnia.Methods:A total of 76 menopausal women with insomnia who were hospitalized from April 2020 to October 2021 were enrolled.Then they were randomly divided into observation group and control group, with 38 cases in each group.Both observation group and control group were treated with CBT-I. Meanwhile, the patients in observation group were treated with low-frequency repetitive rTMS, on the contrary, the patients in control group were treated with sham rTMS.The intervention lasted for 4 weeks.Insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI) and polysomnography (PSG) were all recorded at baseline and 4 weeks after intervention, as well as adverse events. Data was analyzed by SPSS 22.0 software. Data which was normally distributed, was compared by independent t-test and paired t-test. Results:(1)The scores of ISI (16.39±4.03, 15.66±4.89) and the PSQI(14.97±2.70, 14.11±3.60) in observation group and control group at baseline were not significantly different( t=-0.716, -1.190, both P>0.05). After treatment, the ISI and PSQI scores of the observation group (10.08±3.65, 9.58±1.73)were lower than those of the control group (12.82±4.47, 12.13±2.32), and the differences were statistically significant ( t=2.926, 5.440, both P<0.05). (2) After treatment, all sleep parameters were significantly improved from baseline in observation group (all P<0.05). Sleep efficiency, wake time during sleep, and number of awakenings were significantly improved from baseline in control group(all P<0.05). Compared with control group((70.38±12.99)%, (17.39±11.75)%, (13.98±6.35)%), the observation group reported a greater statistically improvement in sleep efficiency, N3% and REM%((79.52±9.31)%, (22.80±6.05)%, (18.78±6.68)%, respectively)( t=-3.526, -2.524, -3.212, all P<0.05). Neither group had serious adverse effects. Conclusion:The rTMS combined with CBT-I can significantly improve the sleep quality in menopausal women with insomnia. With its high safety rTMS combined with CBT-I may be a recommended non-drug therapy among menopausal women with insomnia.
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Objective:To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on awakening of cerebrum frontal lobe area and neural function in the patients with brain injury.Methods:The clinical data of 70 patients with brain injury in Zhejiang Xin′an International Hospital from March 2020 to July 2021 were retrospectively analyzed. Among them, 34 cases were treated with conventional awakening rehabilitation (control group), and 36 cases were treated with rTMS combined with conventional awakening rehabilitation (observation group). The efficacy was evaluated after treatment, the cure and effective were taken as total effective. The Glasgow coma scale (GCS) was used to evaluate the conscious state; the modified coma recovery scale (CRS-R) was used to evaluate the neural function; the brainstem auditory evoked potential (BAEP) classification criteria was used to evaluate the conscious state, the electroencephalogram powers of five channels FP1, F3, C3, F7 and T3 were measured; and the adverse reactions were recorded.Results:The total effective rate in observation group was significantly higher than that in control group: 94.44% (34/36) vs. 76.47% (26/34), and there was statistical difference ( χ2 = 4.61, P<0.05). The eye opening response, motor response, language response and total score of GCS after treatment in observation group were significantly higher than those in control group: (4.28 ± 0.57) scores vs. (3.03 ± 0.59) scores, (4.57 ± 0.85) scores vs. (3.24 ± 0.67) scores, (3.99 ± 0.92) scores vs. (3.01±0.48) scores and (12.85 ± 2.01) scores vs. (10.47 ± 1.95) scores, and there were statistical differences ( P<0.01). The CRS-R score after treatment in observation group was significantly higher than that in control group: (15.28 ± 3.17) scores vs. (12.33 ± 3.09) scores, and there was statistical difference ( P<0.01). The BAEP classification after treatment in observation group was significantly better than that in control group, and there was statistical difference ( P<0.05). The powers of F3, C3, F7 and T3 after treatment in observation group were significantly lower than those in control group: (41.25 ± 6.35) μV 2/Hz vs. (53.19 ± 10.37) μV 2/Hz, (39.17 ± 5.61) μV 2/Hz vs. (48.94 ± 6.63) μV 2/Hz, (63.94 ± 7.57) μV 2/Hz vs. (69.85 ± 7.35) μV 2/Hz and (51.76 ± 6.84) μV 2/Hz vs. (62.47 ± 7.62) μV 2/Hz, and there were statistical differences ( P<0.01); there was no statistical difference in power of Fp1 after treatment between two groups ( P>0.05). No serious complications such as epilepsy occurred in two groups. There was no statistically significant difference in the incidence of adverse reactions between two groups ( P>0.05). Conclusions:The rTMS can improve the excitability of brain cells and the degree of brain injury in patients with brain injury, improve the CRS-R score, promote waking up and the recovery of cognitive functions, with safety and efficiency.
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Post-stroke fatigue is one of the common symptoms of stroke patients. Continuous fatigue will affect the rehabilitation of patients' limb functions, lead to the decline of daily living ability, and at the same time, make patients lack energy, lose the initiative of rehabilitation exercise, and seriously affect the quality of life and social function. This article reviews the epidemiology, clinical characteristics, evaluation scales, influencing factors, pathophysiological mechanism and treatment of post-stroke fatigue.
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Objective:To investigate any anti-aging effect of repeated transcranial magnetic stimulation (rTMS) and explore the relationship between the effect and relief of clinical symptoms in patients with Parkinson′s disease (PD).Methods:A total of 108 PD patients were randomly divided into an rTMS group and a control group, each of 54, while another 54 healthy counterparts were selected to form a normal group. In addition to anti-PD drug therapy, the rTMS group was given daily rTMS treatment, 5 days a week for 4 weeks, while the control group received sham rTMS treatment, with no treatment of the normal group. Before the treatment and after 4 weeks of treatment as well as and 1 month after the ending of the treatment, the subjects′ clinical exercise symptoms were evaluated using the Unified Parkinson′s Disease Rating Scale (UPDRS), a timed exercise test and the 10m re-entry exercise test. Non-exercise symptoms were assessed using the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA) and the Mini-mental State Examination (MMSE). Fasting venous blood samples were analyzed to quantify the serum levels of tumor necrosis factor (TNF), interleukin-6 (IL-6), interleukin-1β (IL-1β) and matrix metalloproteinase-3 (MMP-3).Results:Four weeks and 1 month after the treatment, the average UPDRS scores, exercise test times and 10m re-entry exercise test results of the rTMS group were significantly better than those before treatment and significantly better than those of the control group at the same time point. The rTMS group′s average HAMA, HAMD and MMSE scores, as well as its average P300 latency and amplitude were also significantly better than those of the control group at the same time point and significantly better than those before treatment. After 4 weeks, the average MMP-3 content in the rTMS group was significantly lower than the control group′s average, and after a month the average levels of TNF, IL-6, IL-1β and MMP-3 of the rTMS group were all significantly different from those before treatment and those of the control group. The TNF, IL-6, IL-1β and MMP-3 levels were all positively correlated with the average UPDRS total score.Conclusion:High-frequency rTMS therapy can change the phenotypes related to cell senescence, and thus has good therapeutic effect on motor and non-motor symptoms of PD.
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Objective:To observe the effect of combining biofeedback therapy (BFT) based on virtual reality technology with repeated transcranial magnetic stimulation (rTMS) on dysphagia among stroke survivors.Methods:Eighty patients were randomly divided into a control group, an rTMS group, a BFT group and a combined treatment group, each of 20. In addition to routine dysphagia rehabilitation, the rTMS and BFT groups were given those treatments, while the combined treatment group was given both for 4 weeks. Swallowing function was evaluated before and after the treatment using the standardized swallowing assessment (SSA) and the functional oral intake scale (FOIS). Videofluoroscopy was used to quantify the subjects′ oral and pharyngeal phases and their aspiration status.Results:Significant improvement was observed in the average FOIS and SSA scores, as well as in the average oral and pharyngeal phases and in aspiration. The combined treatment group′s results were significantly better in all those aspects than those of the other 3 groups.Conclusion:The combined application of biofeedback therapy based on virtual reality technology and repeated transcranial magnetic stimulation can improve the swallowing function of stroke survivors with dysphagia. It is worthy of clinical promotion.
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Objective:To investigate any effect of supplementing psychological intervention with repeated transcranial magnetic stimulation (rTMS) in treating depression, improving neurological functioning and improving the life quality of depressed stroke survivors.Methods:A total of 228 patients with post-stroke depression (PSD) were randomly divided into a psychological intervention group, an rTMS treatment group and a combined treatment group, each of 76. In addition to routine stroke treatment and anti-depressant drug treatment, the psychological intervention group received psychological counseling and the rTMS group was given rTMS at 10Hz for 8 weeks. The combined group received both. Before and after the intervention, depression was quantified using the 24-item Hamilton Depression Scale. The National Institutes of Health Stroke Scale was used to quantify neurological functioning. And cognitive functioning was assessed with the Cognitive Function Assessment Scale. Life quality was assessed using the Stroke-specific Quality of Life Scale.Results:After the 8 weeks, significant improvement was observed in the average scores of all three groups on all of the measurements. The combined group had improved significantly more than the other two groups in terms of all of the dimensions studied. The combined group′s clinical remission rate (38.16%) and response rate (85.53%) were significantly higher than those of the other two groups.Conclusions:Repetitive transcranial stimulation can significantly improve the effectiveness of psychological counseling in treating PSD after a stroke. Using them jointly is worthy of application in the clinical practice.
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Objective:To explore the effect of repeated high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex (DLPFC) on the severity and symptoms of Internet addiction.Methods:Fifty college students with different degrees of Internet addiction were randomly divided into a treatment group and a control group, each of 25. In addition to psycho-behavioral therapy, the treatment group was given 10Hz rTMS over the left DLPFC for 40 days, while the control group was given sham stimulation. Before the experiment and after 4 and 8 weeks of treatment, both groups were evaluated using the Internet Addiction Diagnostic Scale (IAT), Barratt Impulsiveness Scale (BIS-11) and a visual analogue scale (VAS).Results:After 4 weeks the average total BIS-11 score, attention factor score and VAS score of the treatment group were significantly better than the control group′s averages and better than before the treatment. After 8 weeks of treatment, the average IAT scores, BIS-11 scores on each item and VAS scores of the treatment group had decreased significantly more and were still significantly better than the control group′s averages.Conclusion:High frequency rTMS can safely and effectively relieve the symptoms of Internet addiction, at least among college students.
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Objective:To explore the effect of combining repetitive transcranial magnetic stimulation (rTMS) with treadmill training in treating spinal cord injury (SCI).Methods:Fifty female Sprague-Dawley rats were randomly divided into a sham-operation (C) group, an SCI group, a treadmill training (TT) group, a treadmill training followed by rTMS (TR) group and an rTMS followed by treadmill training (RT) group. The C group only underwent laminectomy without spinal cord injury, while the model of T9 incomplete spinal cord injury was established in the other groups using the Louisville Injury System Apparatus impactor. One week after the operation the TT began. The TR group received rTMS immediately after the treadmill training and the RT group received it before. The treadmill′s speed started at 3.6m/min and gradually increased to 6m/min within 1 week. There was one 15min session a day, 5 days a week, for 8 weeks in total. The rTMS intensity was 30% of the maximum output intensity at 10Hz in 5s bursts with an interval of 25s. It lasted 10min, for a total of 1000 pulses. Hind limb motor functioning was evaluated using the Basso, Beattie & Bresnahan (BBB) locomotor rating scale and a grid walking test. The H max/M max ratio was used to quantify the excitability of the motor neurons. Immunohistochemistry was employed to detect the expression of 5-hydroxytryptamine (5-HT), 5-hydroxytryptamine 1A receptor (5-HT 1AR) and 5-hydroxytryptamine 2A receptor (5-HT 2AR). Results:The average BBB scores of the RT group were significantly higher than the SCI group′s averages from the 7th to 9th week after the injury. At the ninth week the average BBB score of the RT group was significantly higher than the TT group′s average. At the eighth and ninth week the average BBB scores of the TR group were significantly higher than in the SCI group. The number of drops in the RT group was significantly lower than in the SCI group at the seventh and ninth week. At the ninth week, the number of drops of the TR group was significantly lower compared with the SCI group. The H max/M max ratio of the SCI group was significantly higher than in the C and TR groups at the fifth and ninth week, while that of the TR group was significantly lower than the SCI group′s ratio at the ninth week. The expression of 5-HT, 5-HT 1AR and 5-HT 2AR in the RT and TR groups was significantly higher than in the SCI group, and the relative 5-HT 1AR density of the RT and TR groups was significantly higher than in the SCI and TT groups. Compared with the other 4 groups, the expression of 5-HT 2AR in the SCI group had increased significantly. Conclusions:Combining rTMS with treadmill training can significantly promote the recovery of locomotor function after incomplete spinal cord injury.
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Objective:To observe any effect of repetitive low-frequency transcranial magnetic stimulation (rTMS) on sleep disorders and abnormal behaviors of children on the autism spectrum.Methods:Forty autistic children were randomly divided into an observation group and a control group, each of 20. Both groups were given sleep behavior training and individualized conventional rehabilitation training. Those in the observation group also received 30min of rTMS at 1Hz applied over the left dorsolateral prefrontal cortical area once a day, 5 days a week. Before and after 8 weeks of this treatment, both groups were evaluated using the Autism Behavior Checklist (ABC), the Child Autism Rating Scale (CARS) and the children′s Sleep Habit Questionnaire (CSHQ).Results:The average CARS and CSHQ scores, as well as the total ABC score of both groups increased significantly over the 8 weeks, but the average CARS and CSHQ scores, as well as the total ABC score of the observation group were then significantly better than in the control group. After the treatment, the average ABC scores for sensory ability, communication ability, motor ability, and language ability were significantly lower than before the treatment for both groups, but the observation group′s averages were then significantly better than those of the control group.Conclusions:Supplementing routine intervention with low-frequency rTMS can effectively improve the sleeping and correct the abnormal behavior patterns of autistic children.
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Objective:To observe any effect of combining repetitive transcranial magnetic stimulation (rTMS) under the guidance of event related potentials (ERPs) with action observation therapy (AOT) on the cognitive and motor functioning of stroke survivors in the recovery period.Methods:Ninety stroke survivors were randomly divided into a control group, an rTMS group and an rTMS+ AOT group, each of 30. All three groups were given conventional rehabilitation treatment (including the training of waist, upper and lower limb function, balance, walking, memory, attention, orientation, spatial perception and executive ability). The rTMS group also received one session of ERP-based rTMS daily five times a week. The rTMS+ AOT group was given the same rTMS combined with AOT twice a day, five times a week. Before and after 4 weeks of treatment, the Mini-mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MOCA), the Fugl-Meyer assessment scale (FMA), the Berg Balance Scale (BBS) and the modified Barthel index (MBI) were used to evaluate each subject′s cognitive and motor ability and their skill in the activities of daily living.Results:After the treatment, the average MMSE, MOCA, FMA, BBS and MBI scores of all groups had improved significantly, but the average MMSE, MOCA, upper limb FMA and MBI scores of the rTMS group were then significantly higher than the control group′s averages. And the average scores of the rTMS+ AOT group were significantly better than those of the other two groups.Conclusion:Combining rTMS guided by ERPs with AOT can effectively improve the cognitive functioning, motor control and balance of stroke survivors, and improve their ability in the activities of daily living.
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Objective:To explore the effects of repetitive transcranial magnetic stimulation on balance function in stroke patients.Methods:A total of 238 patients randomized to a rTMS group and a control group by using the random number table at the ratio of 1∶1. Patients in the rTMS group were treated with low-frequency rTMS delivered to the contralateral M1 area, while those in the control group were treated with sham rTMS. The intervention was administered 5 times a week for 4 weeks. Both groups were also treated with conventional physical therapies in addition to rTMS. At one day before the intervention, two days and six weeks after the intervention, Fugl-Meyer Balance Scale, Berg Balance Scale and Modified Barthel index were employed to evaluate the functional outcome of all the patients.Results:After intervention, the scores of Fugl-Meyer Balance Scale, Berg Balance Scale and Modified Barthel index in both groups were significantly improved, and the rTMS group improved significantly more than control group ( P<0.05). When compare to the control group, the rTMS group improved to a significantly greater extent with regard to all the outcomes measures p after intervention and at follow-up ( P<0.05). Conclusion:rTMS is beneficial to the recovery of balance function in patients with stroke.
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Objective:To observe any effect of combining motor imagery therapy (MIT) with repeated transcranial magnetic stimulation (rTMS) for improving upper limb motor functioning after a stroke.Methods:Ninety stroke survivors were randomly divided into a control group, an MIT group and a combination group, each of 30. All received conventional rehabilitation therapy, while the MIT group additionally received MIT and the combination group received the MIT along with 1Hz rTMS applied over the M1 region of the contralateral cortex. Before and after 4 weeks of treatment, everyone′s upper limb functioning was quantified using the Fugl-Meyer assessment scale (FMA) and the Hong Kong version of the hemiplegia upper limb function test (FTHUE-HK). Motor evoked potentials (MEPs), cortical latency (CL) and central motor conduction time (CMCT) were also recorded.Results:After the treatment the average FMA and FTHUE-HK scores of all three groups had improved significantly. The average CL and CMCT were significantly shortened. Compared with the control group, the average upper limb FMA score and FTHUE-HK scores of the treatment group were significantly higher. The combination group showed a significant improvement in its average MEP cortical latency and CMCT values.Conclusions:MIT therapy alone can improve the upper limb motor functioning of stroke survivors, but it is more effective in combination with rTMS.
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Objective:To explore any effect of repeated transcranial magnetic stimulation (rTMS) on the recovery of neurological functioning and the expression of NOD-like receptor family pyrin domain containing 3 (NLRP3) and inflammatory factors after ischemic stroke.Methods:Sixty-four C57BL/6J mice were randomly divided into a normal control group, a model group, a sham stimulation group and an observation group, each of 16. All mice except those of the normal control group received middle cerebral artery occlusion using the suture method to model an ischemic stroke. After the modeling the observation group was given 1Hz rTMS daily for 7 consecutive days, while the sham stimulation group was given sham rTMS. After the intervention, Zea-Longa scores were used for all of the groups, and the size of the cerebral infarct was measured using triphenyltetrazolium chloride staining. The expression of NLRP3 around the cerebral infarction was detected using immunofluorescence, while that in the brain tissue was measured using Western blotting. The expression of interleukin-1β and IL-18 in the brain tissue was detected using enzyme-linked immunosorbent assays.Results:Compared with the normal control group, a significant increase was observed in the other groups′ average neurological function impairment scores. Expression of NLRP3, IL-1β and IL-18 in the model and sham stimulation groups also increased, with large cerebral infarcts in the cortex and hippocampus. Compared with the sham stimulation and model groups, there was a significant decrease in the average neurological dysfunction scores, the area of cerebral infarction in the cortex and hippocampus, as well as the expression of NLRP3, IL-1β and IL-18 in the observation group.Conclusions:Low-frequency rTMS can promote the recovery of damaged nerve function after an ischemic stroke, at least in mice. It can reduce the size of cerebral infarction, and inhibit neuronal pyroptosis, which is closely related to the down-regulation of NLRP3, IL-1β and IL-18 expression.
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Objective:To explore the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on the executive functioning and core symptoms of preschool children on the autism spectrum.Methods:Forty-three preschool children showing signs of autism were randomly divided into an rTMS group of 21 and a control group of 22. In addition to routine rehabilitation and training in basic living skills, the rTMS group was additionally provided with 1Hz rTMS for 8 weeks. Before and after the treatment, both groups were evaluated using the preschool version of the Behavior Rating Inventory for Executive Function (BRIEF-P), the Social Responsiveness Scale (SRS), the revised version of the Repetitive Behavior Scale (RBS-R) and the Child Autism Rating Scale (CARS).Results:After the 8 weeks of treatment, the average BRIEF-P, SRS, RBS-R and CARS scores of both groups had improved significantly, but the rTMS group′s averages where then significantly better than those of the control group.Conclusions:Low-frequency rTMS in addition to conventional rehabilitation intervention can significantly improve the executive functioning and core symptoms of preschool children on the autism spectrum.
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Objective:To observe any effect of repeated transcranial magnetic stimulation (rTMS) in the treatment of diabetic peripheral neuropathic pain (DPNP).Methods:Eighty-six persons with type 2 diabetes mellitus and DPNP were randomly divided into an observation group and a control group, each of 43. Both groups were given basic treatment to control plasma glucose and blood pressure, while the observation group was additionally provided with daily 10Hz rTMS of the primary motor cortex (M1 area) of the non-dominant hand 5 days a week for 4 weeks. Before and after the treatment, pain in both groups was evaluated using a visual analog scale (VAS) and the Patient′s Global Impression Change scale (PGIC). The motor conduction velocity (MCV) and sensory conduction velocity of the median and the common peroneal nerves were also tested.Results:After treatment, the average VAS pain rating and PGIC score of the observation group were significantly lower than the control group′s averages and those before treatment. The observation group′s treatment effectiveness rate (79.07%) was then much better than that of the control group (23.26%). After the treatment, the average MCV of the median and common peroneal nerves of the observation group (47.65±1.94 m/s and 46.98±3.26 m/s, respectively) were significantly faster than before treatment, and those of the control group.Conclusions:rTMS based on routine intervention can significantly relieve DPNP and promote the recovery of injured nerves, bettering diabetics′ physical condition and life quality.
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Objective:To observe any relationship between corticospinal tract integrity and the upper limb motor function of stroke survivors treated with repetitive transcranial magnetic stimulation (rTMS).Methods:Bilateral corticospinal tracts (CSTs) were reconstructed in ischemic or hemorrhagic stroke survivors with upper limb motor dysfunction using diffusion tensor imaging (DTI). Thirty patients with good CST integrity (rFA>0.5) and 30 with rFA≤0.5 were further divided into a high frequency rTMS group (HF, n=10), a low frequency group (LF, n=10), and a control group ( n=10). All groups were given routine rehabilitation, while the high and low frequency groups were additionally provided with 5Hz and 1Hz rTMS respectively applied over the M1 area of the contralesional hemisphere. Before and after 3 weeks of treatment, all of the subjects were evaluated using the Fugl-Meyer upper extremity scale (F-M UE), the Wolf Motor Function Test (WMFT) and the Modified Barthel Index (MBI). Results:For the high CST integrity group, significant improvement was observed in the average scores of all measurements, with the average FMA-UE, WMFT and MBI scores of the LF group [(38.10±5.71), (43.20±5.32) and (78.00±11.35)] significantly better than those of the other 2 groups. Among the low CST integrity group, the HF subgroup showed greater improvement than the other 2 on average.Conclusions:For patients with good CST integrity, LF-rTMS over the contralesional cortex is superior to HF-rTMS in promoting upper limb motor function, while for patients with low CST integrity HF-rTMS over the contralesional cortex has a better effect than LF-rTMS or sham stimulation in terms of improving upper limb motor function after a stroke.