Study On The Efficacy Of RTMS With Different Stimulation Parameters In The Treatment Of PSCIND

Objective This study aimed to observe the clinical effect of repetitive transcranial magnetic stimulation with different stimulation parameters of patients with post stroke cognitive impairment non-dementia,and to compare the efficacy of theta burst stimulation with conventional high-frequency and low-frequency stimulation,so as to provide a better guidance for clinical practice.Methods A total of 75 patients of PSCIND admitted to the Department of Neurology of our hospital from September 2021 to December 2021 were collected and randomly divided into the control group,conventional group and TBS group according to the order of hospitalization,25 people in each group.The control group was given medication,rehabilitation therapy and cognitive training for the corresponding basic diseases.In addition to the above-mentioned treatments,TMS group was treated with rTMS in different parametric modes: 1.TBS group:Intermittent burst stimulation(iTBS)was performed at the left dorsolateral prefrontal cortex(DLPFC)at the frequency of 50 Hz;Then 50 Hz continuous burst stimulation(c TBS)was performed on the right DLPFC.2.Routine group: High-frequency stimulation at 10 Hz was performed before the left DLPFC;Then the right DLPFC was subjected to 1 Hz lowfrequency stimulation.Before and after treatment,the Mini-Mental Status Examination(MMSE),Montreal cognitive assessment(MoCA)and Activity of Daily Living(ADL)were used to measure the cognitive function and activity of daily living.Results(1)General information: There is no significant difference in gender,age,education level,cerebrovascular disease types and years of education among the three groups of patients(P > 0.05),indicating comparability.(2)Before treatment,there was no statistical difference in the total scores of the three kinds of scores between groups(P > 0.05).Comparison between groups after treatment:There was no significant difference in the total score between the three groups(P>0.05).Among them,comparing MMSE "memory and recall" and MoCA "delayed recall" among the three groups,the difference was statistically significant(P<0.05),and the improvement was more obvious in TBS group.(3)Comparison before and after the group: After the treatment,the total scores of MMSE,MoCA and ADL in the three groups were all higher than before,and the difference was statistically significant(P<0.05).After treatment,MMSE orientation,memory and recall,language ability and delayed recall of MoCA in the three groups were all improved compared with those before treatment,and the difference was statistically significant(P<0.05).(4)Comparison of differences: Compared with the control group,the scores of MMSE and MoCA in TMS group were significantly higher(P<0.05),especially in TBS group(P<0.05);There was no significant improvement in ADL scores among the three groups(P>0.05).Conclusion For PSCIND patients,rTMS with different stimulation parameters can improve cognitive function,among which TBS mode is more effective than conventional mode rTMS,especially in MMSE "memory and recall" and MoCA "delayed recall",which is worthy of clinical application and further promotion.The improvement of daily living ability still needs further study.