10.3760/cma.j.issn.0254-1424.2022.12.104
Accelerated rTMS and cognitive training in chronic stroke: a safety and feasibility study
Objective:We examined the safety of accelerated rTMS as well as its feasibility in a delivery schedule interleaved with computerized cognitive training in individuals with chronic stroke and cognitive impairment.Methods:Fourteen chronic stroke patients with intact left prefrontal cortex who met DSM-5 criteria for mild neurocognitive disorder completed open-label high-dose rTMS (intermittent theta burst) to left dlPFC (600 pulses, eight sessions/day for three days), interleaved every 15 minutes between cognitive training sessions. Participants completed at pre- and post-treatment: 1) neuroradiological lesion characterization and safety assessment with flair, diffusion, susceptibility, angiography, perfusion gradient and volumetric scans, 2) neuropsychological and psychosocial assessment as well as assessment of neglect and aphasia, and 3) ratings of treatment acceptability and credibility.Results:No study-related adverse events occurred as indexed in neuroradiological, neuropsychological or subjective quantitative or qualitative report of side effects. Accelerated rTMS was rated as acceptable and credible with no more than minor discomfort in line with conventional once daily delivery schedules. Retention was feasible as all participants who began treatment completed.Conclusions:This is the first comprehensive neuroradiological and neuropsychological examination of the safety of accelerated rTMS in chronic stroke, or any condition. Across objective and subjective indices, up to 24 sessions of accelerated intermittent theta burst rTMS was safe, acceptable, and tolerable, even in a neurologically vulnerable condition such as chronic stroke.
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2023-05-30(万方平台首次上网日期,不代表论文的发表时间)
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