Effect of transcranial magnetic stimulation combined with exercise therapy on fatigue and inflammatory cytokines in patients with post-stroke fatigue / 中华物理医学与康复杂志

ABSTRACT

Objective To observe the effects of transcranial magnetic stimulation combined with exercise training on fatigue and interleukin-1β (IL-1β),interleukin-9,interleukin-10,tumor necrosis factor-α and C-reactive protein (CRP) in patients with post-stroke fatigue (PSF).Methods A total of 90 patients with post-stroke fatigue were recruited and randomly divided into an observation group and a control group.Both groups were given routine exercise training,and the observation group was treated with transcranial magnetic stimulation in addition.Simplified Fugl-Meyer Motor Function Scale (FMA) and Fatigue Severity Scale (FSS) were used to assess the motor function of the limbs and fatigue of the two groups before treatment,4 and 8 weeks after treatment.At the same time,the levels of IL-1 β,IL-9,IL-10,TNF-α and CRP in the serum of the two groups were measured at the above time points.The correlation among the motor function,fatigue and cytokine levels was analyzed.Results There was no significant difference in the levels of IL-1β,IL-9,IL-10,TNF-α and CRP between the two groups before treatment (all P＞0.05);FMA score and fatigue improvement in the observation group were significantly better than those in the control group after treatment for 4 and 8 weeks (all P＜0.05);and serum levels of IL-1β,IL-9,IL-10,TNF-α and CRP in the observation group were significantly lower than those in the control group after treatment (all P＜0.05).Pearson correlation analysis showed that FMA scores of limbs were negatively correlated with serum levels of IL-1β,IL-9,IL-10,TNF-α and CRP (P＜0.05),and FSS scores were positively correlated with serum levels of IL-1β,IL-9,IL-10,TNF-α and CRP (P＜0.05).Conclusion Transcranial magnetic stimulation combined with exercise therapy can significantly improve the motor function and ameliorate fatigue of PSF patients.The therapeutic mechanism may be related to the reduction of serum levels of IL-1β,IL-9,IL-10,TNF-α and CRP.