The impact of high-frequency rTMS treatment on brain activity in PSCI patients: a TMS-EEG study

ObjectivesThis study employed Transcranial Magnetic Stimulation combined with Electroencephalography (TMS-EEG) to examine the impacts of high-frequency repetitive transcranial magnetic stimulation (rTMS) on brain activity and cognitive function in patients with post-stroke cognitive impairment (PSCI...

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Main Authors: Xinxin Song, Jianming Fu, Yunhai Yao, Yuhong Shu, Zhongli Wang, Xuting Chen, Lianjie Ma, Fang Shen, Xiaolin Sun, Xiaoqing Ma, Ting Zhang, Rujue Jin, Ming Zeng, Xudong Gu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1582437/full
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author Xinxin Song
Jianming Fu
Yunhai Yao
Yuhong Shu
Zhongli Wang
Xuting Chen
Lianjie Ma
Fang Shen
Xiaolin Sun
Xiaoqing Ma
Ting Zhang
Rujue Jin
Ming Zeng
Xudong Gu
author_facet Xinxin Song
Jianming Fu
Yunhai Yao
Yuhong Shu
Zhongli Wang
Xuting Chen
Lianjie Ma
Fang Shen
Xiaolin Sun
Xiaoqing Ma
Ting Zhang
Rujue Jin
Ming Zeng
Xudong Gu
author_sort Xinxin Song
collection DOAJ
description ObjectivesThis study employed Transcranial Magnetic Stimulation combined with Electroencephalography (TMS-EEG) to examine the impacts of high-frequency repetitive transcranial magnetic stimulation (rTMS) on brain activity and cognitive function in patients with post-stroke cognitive impairment (PSCI), focusing on changes in connectivity of the left dorsolateral prefrontal cortex (DLPFC) across different frequency bands.MethodsTwenty subacute PSCI patients were recruited for a 20-day rTMS treatment, consisting of 10 days of sham stimulation followed by 10 days of actual stimulation. Clinical function scale data and TMS-EEG data were collected before treatment (Pre), after sham stimulation (Sham), and after rTMS treatment (TMS) to analyze transcranial magnetic stimulation evoked potentials (TEP), time-frequency, and functional connectivity. Additionally, a post hoc subgroup analysis was conducted to assess the impact of education level, time since onset, and lesion size on cognitive score improvement.ResultsCompared to the Pre and Sham conditions, cognitive function and daily living ability scores significantly improved post-rTMS. Although the TEP patterns in the Pre and Sham conditions were similar, rTMS enhanced the early TEP amplitude in the left DLPFC, slowed gamma oscillations, increased connectivity in the theta and alpha bands in the bilateral DLPFC, and altered the connectivity patterns between the left DLPFC and other brain regions. Changes in theta-band wPLI were significantly positively correlated with improvements in MMSE scores (r = 0.465, p = 0.039) and MoCA scores (r = 0.493, p = 0.027). Patients with higher education levels exhibited significant cognitive improvement (p = 0.039), while patients with a time since onset of 60–180 days showed a significant decline in cognitive improvement (p = 0.024).ConclusionHigh-frequency rTMS effectively modulated connectivity patterns between the left DLPFC and other brain regions in PSCI patients, enhancing cognitive functions. Changes in wPLI within the theta frequency band may serve as a potential biomarker for cognitive function improvement in PSCI patients. Education level and time since onset may have a certain impact on cognitive improvement in PSCI patients.
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spelling doaj-art-61d063e0176e4dc3af9a304eb7ba043a2025-08-20T02:31:12ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15824371582437The impact of high-frequency rTMS treatment on brain activity in PSCI patients: a TMS-EEG studyXinxin Song0Jianming Fu1Yunhai Yao2Yuhong Shu3Zhongli Wang4Xuting Chen5Lianjie Ma6Fang Shen7Xiaolin Sun8Xiaoqing Ma9Ting Zhang10Rujue Jin11Ming Zeng12Xudong Gu13Joint Training Base of Zhejiang Chinese Medical University and Jiaxing University, Hangzhou, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaJoint Training Base of Zhejiang Chinese Medical University and Jiaxing University, Hangzhou, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaRehabilitation Medicine Center, Second Affiliated Hospital of Jiaxing University, Jiaxing, ChinaObjectivesThis study employed Transcranial Magnetic Stimulation combined with Electroencephalography (TMS-EEG) to examine the impacts of high-frequency repetitive transcranial magnetic stimulation (rTMS) on brain activity and cognitive function in patients with post-stroke cognitive impairment (PSCI), focusing on changes in connectivity of the left dorsolateral prefrontal cortex (DLPFC) across different frequency bands.MethodsTwenty subacute PSCI patients were recruited for a 20-day rTMS treatment, consisting of 10 days of sham stimulation followed by 10 days of actual stimulation. Clinical function scale data and TMS-EEG data were collected before treatment (Pre), after sham stimulation (Sham), and after rTMS treatment (TMS) to analyze transcranial magnetic stimulation evoked potentials (TEP), time-frequency, and functional connectivity. Additionally, a post hoc subgroup analysis was conducted to assess the impact of education level, time since onset, and lesion size on cognitive score improvement.ResultsCompared to the Pre and Sham conditions, cognitive function and daily living ability scores significantly improved post-rTMS. Although the TEP patterns in the Pre and Sham conditions were similar, rTMS enhanced the early TEP amplitude in the left DLPFC, slowed gamma oscillations, increased connectivity in the theta and alpha bands in the bilateral DLPFC, and altered the connectivity patterns between the left DLPFC and other brain regions. Changes in theta-band wPLI were significantly positively correlated with improvements in MMSE scores (r = 0.465, p = 0.039) and MoCA scores (r = 0.493, p = 0.027). Patients with higher education levels exhibited significant cognitive improvement (p = 0.039), while patients with a time since onset of 60–180 days showed a significant decline in cognitive improvement (p = 0.024).ConclusionHigh-frequency rTMS effectively modulated connectivity patterns between the left DLPFC and other brain regions in PSCI patients, enhancing cognitive functions. Changes in wPLI within the theta frequency band may serve as a potential biomarker for cognitive function improvement in PSCI patients. Education level and time since onset may have a certain impact on cognitive improvement in PSCI patients.https://www.frontiersin.org/articles/10.3389/fneur.2025.1582437/fullpost-stroke cognitive impairmentrepetitive transcranial magnetic stimulationTEPSTMS-EEGEEG functional connectivity
spellingShingle Xinxin Song
Jianming Fu
Yunhai Yao
Yuhong Shu
Zhongli Wang
Xuting Chen
Lianjie Ma
Fang Shen
Xiaolin Sun
Xiaoqing Ma
Ting Zhang
Rujue Jin
Ming Zeng
Xudong Gu
The impact of high-frequency rTMS treatment on brain activity in PSCI patients: a TMS-EEG study
Frontiers in Neurology
post-stroke cognitive impairment
repetitive transcranial magnetic stimulation
TEPS
TMS-EEG
EEG functional connectivity
title The impact of high-frequency rTMS treatment on brain activity in PSCI patients: a TMS-EEG study
title_full The impact of high-frequency rTMS treatment on brain activity in PSCI patients: a TMS-EEG study
title_fullStr The impact of high-frequency rTMS treatment on brain activity in PSCI patients: a TMS-EEG study
title_full_unstemmed The impact of high-frequency rTMS treatment on brain activity in PSCI patients: a TMS-EEG study
title_short The impact of high-frequency rTMS treatment on brain activity in PSCI patients: a TMS-EEG study
title_sort impact of high frequency rtms treatment on brain activity in psci patients a tms eeg study
topic post-stroke cognitive impairment
repetitive transcranial magnetic stimulation
TEPS
TMS-EEG
EEG functional connectivity
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1582437/full
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