Application of rhythmic transcranial magnetic stimulation with low-intensive running pulsed magnetic field in the rehabilitation of patients with post-stroke cognitive impairment syndrome

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Abstract

The purpose of the investigation was to study the nootropic effects of rhythmic transcranial magnetic stimulation (rTMS) using low-intensity magnetic field with the induction rate of 45 mT, base frequency of 50 Hz, modulation frequency of 10 Hz in combination with standard medical and psychological therapy in the rehabilitation of patients with post-stroke cognitive impairment (PSCI).

Materials and methods. The rehabilitation outcomes in 98 patients with PSCI syndrome were studied. The patients were subdivided into 2 groups: 53 patients of the control group were treated with the standard nootropic medications and neuropsychological procedures; 45 patients of the main group were additionally treated with rTMS by the low-intensive running pulsed magnetic field of 10 Hz modulation frequency. The dynamics of the score increase according to Rivermid, Karnovsky, Roshina, MMSE, mRS, HDRS, SF-36 scales were analyzed.

Conclusion. Application of rTMS with low-intensive running pulsed magnetic field of 10 Hz modulation frequency in combination with a standard program of cognitive rehabilitation contributes to a significant improvement in the recovery of mental calculation function in ischemic stroke patients, as well as normalization in mood swings in the patients who had suffered a hemorrhagic stroke and post-stroke depression. This variant of rTMS can be safely used in patients with PSCI syndrome in the early recovery period, 3 weeks after the onset of stroke.

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About the authors

Alexey Е. Tereshin

North-Western State Medical University named after I.I. Mechnikov; Nikolaevskaya Hospital

Author for correspondence.
Email: aet-spb@yandex.ru
ORCID iD: 0000-0002-1982-8620
SPIN-code: 8637-8007
Scopus Author ID: 650801
ResearcherId: D-9465-2019
https://ridero.ru/books/uchimsya_zhit_bez_tabletok/

MD, PhD, docent of phisical medicine and rehabilitation faculty; head of rehabilitation departmet

Russian Federation, 191015, St. Petersburg, Kirochnaya str., 41; 198510, St. Petersburg, Petergof, Konstantinovskaya str., 1

Vera V. Kiryanova

North-Western State Medical University named after I.I. Mechnikov

Email: kiryanova_vv@mail.ru
SPIN-code: 1461-5963
Scopus Author ID: 342702

MD, PhD, docent of phisical medicine and rehabilitation faculty

Russian Federation, 191015, St. Petersburg, Kirochnaya str., 41

Dmitry A. Reshetnik

Nikolaevskaya Hospital

Email: b37@zdrav.spb.ru
Scopus Author ID: 420636

Chief medical officer

Russian Federation, 198510, St. Petersburg, Petergof, Konstantinovskaya str., 1

Marina V. Karyagina

Nikolaevskaya Hospital

Email: kmv-spb@list.ru
ORCID iD: 0000-0002-5931-3015

Кандидат медицинских наук, врач-невролог отделения реабилитации

Russian Federation, 198510, St. Petersburg, Petergof, Konstantinovskaya str., 1

Elena K. Savelyeva

Nikolaevskaya Hospital

Email: save.alena2010@yandex.ru

neuropsychologist

Russian Federation, 198510, St. Petersburg, Petergof, Konstantinovskaya str., 1

Maria Yu. Efimova

Nikolaevskaya Hospital

Email: medice_levsha@mail.ru
ORCID iD: 0000-0002-0145-8211
ResearcherId: E-2328-2019
http://education.almazovcentre.ru/about_institute/kafedra/nevrologii_i_psihiatrii/sotrudniki/efimova-maria-urievna/

Neurologist, rehabilitation department

Russian Federation, 198510, St. Petersburg, Petergof, Konstantinovskaya str., 1

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2. Fig. 1. Comparison of the dynamics of points growth on functional scales and the Shulte test in the main and control groups. The differences are not significant

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3. Fig. 2. Comparison of the dynamics of score growth on the functional state evaluation scales, emotional and cognitive functions in the main and control groups. No significant differences were found. HDRS — Hamilton Rating Scale for Depression; FAB — Frontal Assessment Battery; MMSE — Mini mental State Examination

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4. Fig. 3. Comparison of the dynamics of score growth according to the results of neuropsychological and speech testing and the modified Rankin scale in the main and control groups. * the difference is significant (p = 0.01)

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5. Fig. 4. Comparison of the dynamics of growth points on the scale of quality of life SF-36 in the main and control groups. No significant changes were found. PF — physical functioning; RP — role-physical functioning; BP — bodily pain; GH — general health; VT — vitality; SF — social functioning; RE — role-emotional functioning; MH — mental health; PHsum — physical component of health; MHsum — mental component of health

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Copyright (c) 2020 Tereshin A.Е., Kiryanova V.V., Reshetnik D.A., Karyagina M.V., Savelyeva E.K., Efimova M.Y.

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