The effects of repetitive transcranial magnetic stimulation on awakening and neural function in patients with brain injury / 中国医师进修杂志

ABSTRACT

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.