Effects of high frequency repetitive transcranial magnetic stimulation on executive function in patients after stroke

Objective To observe the effect of high frequency repetitive transcranial magnetic stimulation (rTMS) on executive function in patients after stroke. Methods Thirty-six stroke patients with executive dysfunction in the Second Affiliated Hospital of Guangzhou Medical University from March 2016 to April 2017 were randomly divided into experimental group (n=18) and control group (n=18). The experimental group received 10 Hz rTMS of the left dorsolateral prefrontal cortex(DLPFC)and cognitive functional training, while the control group received sham rTMS and cognitive functional training, for four weeks. Mini-Mental State Examination(MMSE), Wisconsin Card Classification Test(WCST), Digit Symbol Test(DST)and Digital Span(DS)were used for cognitive assessment at baseline and therapy completed. Results After a four weeks therapy, the total number of responses showed no significant difference in WCST between two groups. But the control group after treatment showed that MMSE score (17.44±4.73) and DST score (4.50 (2.75, 8.25)) were improved compared with that before treatment (MMSE score 15.28±4.61, t=-8.371, P=0.000; DST score 4.00 (2.75, 7.25), Z=-2.122, P=0.049), and the DS score and the numbers of correction, classification and continuous errors of WCST showed no significant difference compared with that before treatment. The experimental group after treatment showed that MMSE score (20.67±4.59), DST score (7.50(4.75, 12.50)), DS score (recite in order 7.00 (7.00, 8.00), recite in reverse order 3.00 (2.00, 4.00)), the numbers of correction of WCST (24.61±8.30), the numbers of continuous errors (12.17±5.08), the numbers of classification (2.00 (2.00, 3.00) were improved compared with that before treatment (MMSE score 15.50±5.24, t=-21.013, P=0.000; DST score 3.00(1.00, 7.00), Z=-3.757, P=0.000; DS score recited in order 6.00(5.00, 6.00), Z=-3.703, P=0.000; DS score recited in reverse order 2.00(1.00, 3.00), Z=-3.494, P=0.000; The numbers of correction of WCST (16.50±9.34), t=-6.544, P=0.000); The numbers of continuous errors (18.06±5.63, t=9.744, P=0.000); The numbers of classification (1.00(1.00, 2.00), Z=-3.900, P=0.000). And the curative effect was better than that of control group. Conclusion High frequency rTMS combined with cognitive function training can improve the executive dysfunction of stroke patients, and the improvement is better than cognitive functional training alone.