Evaluation of the effectiveness of the method of treatment of cognitive disorders with the integrated use of transcranial magnetic stimulation in ischemic stroke patients in the late recovery period

Background. Cognitive impairment (CI) in ischemic stroke (IS) patients occupies up to 80% in the general classification. It is they that can challenge the rehabilitation, noticeably worsening the overall quality of life of a patient, as well as increasing the likelihood of developing a recurrent cerebral infarction. Objective. Evaluation of the effectiveness of transcranial magnetic stimulation in the complex treatment of patients with CI in the late recovery period of IS. Methods. In 2017-2019, a non-randomized prospective study included 200 neurologic patients who experienced acute ischemic cerebrovascular accident in the late recovery period. All patients were divided into two groups: group I (main)-100 patients (52 men and 48 women aged 45-75 years) and group II (control) - 100 patients (55 men and 45 women aged 45-75 years). Treatment efficacy was assessed by methods for quantifying the neurological deficit and associated conditions using the integral scales (Scandinavian Stroke Study Group (SSSG), National Institutes of Health Stroke Scale (NIHSS), Barthel Index, Rankin scale), and quantitative assessment of basic cognitive functions by the neuropsychological testing (tests to assess attention, perception, memory, mental functions, impaired speech function, MMSE scale). Results. Compared to the control group, patients of the main group showed a statistically significant improvement according to most methods for assessing CI, as well as a significant improvement in the overall neurological deficit. Conclusion. The inclusion of transcranial magnetic stimulation in the complex treatment of CI in patients in the late recovery period of IS leads to an improvement not only in particular cognitive functions: attention, perception, memory, motor speech and praxis, but also in general cognitive status, which is confirmed statistically by the results of its integrated assessment.

ischemic stroke, late recovery period, cognitive impairment, transcranial magnetic stimulation