IMR Press / JIN / Volume 21 / Issue 5 / DOI: 10.31083/j.jin2105130
Open Access Original Research
Efficacy of Intermittent Theta-Burst Stimulation and Transcranial Direct Current Stimulation in Treatment of Post-Stroke Cognitive Impairment
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1 The Third Clinical Medical College, Zhejiang Chinese Medical University, 310053 Hangzhou, Zhejiang, China
2 The Third Affiliated Hospital of Zhejiang Chinese Medical University, 310013 Hangzhou, Zhejiang, China
3 Department of Geriatric Rehabilitation Center, Zhejiang Rehabilitation Medical Center, 310053 Hangzhou, Zhejiang, China
4 Department of Hangzhou Innovation Institute, Beihang University, 310053 Hangzhou, Zhejiang, China
5 Department of Neurology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, 310013 Hangzhou, Zhejiang, China
6 Department of Center for Rehabilitation Assessment and Therapy, Zhejiang Rehabilitation Medical Center, 310053 Hangzhou, Zhejiang, China
7 Department of Encephalopathy Rehabilitation Center, Zhejiang Rehabilitation Medical Center, 310053 Hangzhou, Zhejiang, China
8 Integrated Medicine Research Center for Neurological Rehabilitation, College of Medicine, Jiaxing University, 314001 Jiaxing, Zhejiang, China
9 Department of Pharmacy, College of Medicine, Jiaxing University, 314001 Jiaxing, Zhejiang, China
*Correspondence: cje28@foxmail.com (Jianer Chen)
These authors contributed equally.
Academic Editor: Jesús Pastor
J. Integr. Neurosci. 2022, 21(5), 130; https://doi.org/10.31083/j.jin2105130
Submitted: 9 March 2022 | Revised: 12 May 2022 | Accepted: 23 May 2022 | Published: 21 July 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: The efficacy of intermittent theta-burst stimulation (iTBS) and transcranial direct current stimulation (tDCS) combined with cognitive training in the treatment of post-stroke cognitive impairment (PSCI) requires further investigation. Methods: We randomly assigned 60 patients with PSCI to receive iTBS (n = 21), tDCS (n = 19), or cognitive training alone (n = 20). Cognitive function was evaluated by the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and the performance of activities of daily living (ADL) was assessed with the modified Barthel Index (MBI). Of these patients, 14 participated in the functional near-infrared spectroscopy (fNIRS) measurement. Results: After six weeks of treatment, cognitive function improved in all three groups of PSCI patients. Compared with patients receiving only cognitive training, the cognitive function of patients in the iTBS combined with cognitive training (p = 0.003) and tDCS combined with cognitive training groups (p = 0.006) showed greater improvement. The cognitive improvement from tDCS was related to the activation of the frontopolar cortex (FPC), while the improvement of cognition by iTBS was based on the activation of the stimulation site (the dorsolateral prefrontal cortex) and some distant regions. Conclusions: Both iTBS and tDCS in addition to cognitive training appear to improve cognitive function and quality of life of patients with PSCI, compared to cognitive training alone. tDCS improved cognitive function by improving the patient’s valuation, motivation, and decision-making substructures, while iTBS improved patients’ assessment and decision-making abilities, improving cognitive control and, ultimately, overall cognitive function.

Keywords
post-stroke cognitive impairment
intermittent theta-burst stimulation
transcranial direct current stimulation
functional near-infrared spectroscopy
Funding
2021C03050/Key Research and Development Program of Zhejiang Province
ZK2001/Scientific Research Program of Zhejiang Rehabilitation Medical Center
Figures
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