Effects of combined use of intermittent theta burst stimulation and cognitive training on post-stroke cognitive impairment : a single-blind randomized controlled trial

Abstract

Objective Post-stroke cognitive impairment (PSCI) substantially affects patients’ quality of life. This study explored the therapeutic efficacy of intermittent theta burst stimulation (iTBS) combined with cognitive training for PSCI. Design The experimental group received iTBS and cognitive training, whereas the control group only received cognitive training, both for six weeks. The outcome measures were the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Modified Barthel Index (MBI), Transcranial Doppler Ultrasonography (TCD), and Functional Near-infrared Spectroscopy (fNIRS). Results After therapy, between-group comparisons revealed a substantial difference in the LOTCA scores (P = 0.024). Improvements in visuomotor organization and thinking operations were more noticeable in the experimental group than in the other groups (P = 0.017 and P = 0.044, respectively). After treatment, the resistance index of the experimental group differed from that of the control group; channels 29, 37, and 41 were activated(P < 0.05). The active locations were the left dorsolateral prefrontal cortex (DLPFC), prefrontal polar cortex, and left Broca’s region. Conclusion iTBS combined with cognitive training had a superior effect on improving cognitive function and everyday activities compared with cognitive training alone, notably in visuomotor organization and thinking operations. iTBS may enhance cognitive performance by improving network connectivity.

Activation changes in patients with post-stroke cognitive impairment receiving intermittent theta burst stimulation: A functional near-infrared spectroscopy study

“…Compared with the previous similar studies (Chu et al, 2022;Zhang et al, 2023), this study provided more robust fNIRS evidence contributing to cortical activation induced by iTBS, indicating that iTBS could restore of brain network plasticity. The activation of the left FPC aligns with the findings of Chu et al (2022) and Zhang et al (2023), suggesting its significance in executive function.…”

“…Compared with the previous similar studies (Chu et al, 2022;Zhang et al, 2023), this study provided more robust fNIRS evidence contributing to cortical activation induced by iTBS, indicating that iTBS could restore of brain network plasticity. The activation of the left FPC aligns with the findings of Chu et al (2022) and Zhang et al (2023), suggesting its significance in executive function. The interaction among the FPC, the posterior cingulate gyrus and the ventrolateral prefrontal cortex supports goal-directed behavior, provides a working memory system, responsible for activating and selecting task-related information stored in the posterior cortex, and is involved in making a plan (Domic-Siede et al, 2021;Costa et al, 2013).…”