Evaluation of the effectiveness of the method of treatment of cognitive disorders with the integrated use of transcranial magnetic stimulation in ischemic stroke patients in the late recovery period

Pharmateca ◽  
2020 ◽  
Vol 13_2020 ◽  
pp. 108-113
Author(s):  
A.A. Rakhmanova Rakhmanova ◽  
A.P. Skorokhodov Skorokhodov ◽  
V.A. Kutashov Kutashov ◽  
Stroke ◽  
1999 ◽  
Vol 30 (12) ◽  
pp. 2666-2670 ◽  
Author(s):  
Giovanni Pennisi ◽  
Giuseppe Rapisarda ◽  
Rita Bella ◽  
Vittorio Calabrese ◽  
Alain Maertens de Noordhout ◽  
...  

2017 ◽  
Vol 8 (2) ◽  
pp. 42-48
Author(s):  
E V Ekusheva ◽  
E S Kiparisova ◽  
E V Shirshova

The aim of the study was to investigate the clinical and neurophysiological features of sensorimotor disturbances in patients at different time periods after ischemic stroke. Methods. The study involved 133 patients with ischemic stroke in the right and left cerebral hemispheres in the late recovery (58) and residual (75) periods. There were 35 controls. Were performed transcranial magnetic stimulation, evoked abdominal reflexes and somatosensory evoked potentials. Results. It was shown that functional recovery processes are continuing with varying degrees of severity in patients and in a year after stroke. Conclusions. Persistence and severity of sensorimotor disturbances, as well as compensatory opportunities, defined afferent component of poststroke deficit, which implies an additional impact in this area to expand the possibilities of neurorehabilitation in patients after stroke.


Author(s):  
Novika Azirah Azis ◽  
Jumraini Tammasse ◽  
Abdul Muis

  THE INFLUENCE OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS) TOWARDS IMPAIRED COGNITIVE FUNCTION AFTER ISCHEMIC STROKEABSTRACTIntroduction: The increasing number of ischemic stroke patients who experience memory disturbances and a long rehabilitation process requires an innovation that can strengthen both existing therapies (medical therapy) and non-invasive stimulation of cognitive rehabilitation in the form of repetitive transcranial magnetic stimulation (rTMS).Aim: To determine effectiveness of rTMS towards impaired cognitive function in ischemic stroke.Methods: This research was conducted using experimental with open clinical trial test method  on ischemic stroke patients suffering from cognitive impairment at Wahidin Sudirohusodo Hospital and Inggit Clinic, Makassar, from November 2018 until January 2019. Samples were divided into control who was given only medical therapy and treatment group who was given medical therapy and rTMS. Stimulation is given in the form of a high frequency of 10Hz in 2 cycles for 5 consecutive days with a gap of 2 days. MoCA-Ina was used to assess cognitive impairment. The assessment were made on day-1 before therapy and day-15 after therapy. The statistical analysis of correlation among variables was conducted by using Chi-square test with value of p <0.05 which was considered significant.Results: There were 22 samples, 11 in each group. The difference of MoCA-Ina scores in both groups with the final average after 15 days of treatment was 5.27 in the treatment group and 1.45 in control group. This difference is considered significant with the p value of 0.003.Discussion: There was an effect of rTMS therapy on cognitive function disorders after ischemic stroke, in which the change was greater in the treatment group than in the control group.Keywords: Cognitive impairment, ischemic stroke, Montreal Cognitive Assesment Indonesian Version (MoCA-Ina), repetitive transcranial magnetic stimulation (rTMS)ABSTRAKPendahuluan: Peningkatan jumlah pasien stroke iskemik yang mengalami gangguan memori serta proses rehabilitasi yang lama membutuhkan suatu inovasi yang dapat saling menguatkan antara terapi yang sudah ada (terapi medik) dan stimulasi non-invasif rehabilitasi kognitif berupa repetitive transcranial magnetic stimulation (rTMS).Tujuan: Mengetahui pengaruh intervensi rTMS terhadap fungsi kognitif pascastroke iskemik.Metode: Penelitian eksperimental dengan uji klinis terbuka terhadap pasien stroke iskemik yang menderita gangguan fungsi kognitif di RSUP Dr. Wahidin Sudirohusodo dan Klinik Inggit Medika, Makassar, pada bulan November 2018 hingga Januari 2019. Subjek dibagi ke dalam kelompok kontrol yang diberikan terapi medikamentosa saja serta kelompok perlakuan yang diberikan terapi medikamentosa dan intervensi rTMS. Stimulasi diberikan berupa frekuensi tinggi 10Hz dalam 2 siklus selama 5 hari berturut-turut dengan jeda waktu 2 hari. Penilaian gangguan kognitif menggunakan Montreal Cognitive Assesment versi Indonesia (MoCA-Ina). Pengukuran dilakukan pada hari-1 pre-terapi dan hari ke-15 pascaterapi. Data dianalisis secara statistik menggunakan uji Chi-square dengan nilai p<0,05 dianggap bermakna.Hasil: Terdapat 22 subjek yang masing-masing terdiri dari 11 subjek pada kelompok kontrol dan perlakuan. Selisih skor MoCA-Ina pada kedua kelompok dengan rerata akhir setelah lima belas hari perlakuan sebesar 5,27 pada kelompok perlakuan dan 1,45 pada kelompok kontrol yang bermakna (p=0,003).Diskusi: Terdapat pengaruh terapi rTMS terhadap gangguan fungsi kognitif pascastroke yang lebih besar pada kelompok perlakuan dibanding kelompok kontrol.Kata kunci: Gangguan kognitif, Montreal Cognitive Assesment versi Indonesia (MoCA-Ina), repetitive transcranial magnetic stimulation (rTMS), stroke iskemik  


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Francesco Di Gregorio ◽  
Fabio La Porta ◽  
Emanuela Casanova ◽  
Elisabetta Magni ◽  
Roberta Bonora ◽  
...  

Abstract Background Left hemispatial neglect (LHN) is a neuropsychological syndrome often associated with right hemispheric stroke. Patients with LHN have difficulties in attending, responding, and consciously representing the right side of space. Various rehabilitation protocols have been proposed to reduce clinical symptoms related to LHN, using cognitive treatments, or on non-invasive brain stimulation. However, evidence of their benefit is still lacking; in particular, only a few studies focused on the efficacy of combining different approaches in the same patient. Methods In the present study, we present the SMART ATLAS trial (Stimolazione MAgnetica Ripetitiva Transcranica nell’ATtenzione LAteralizzata dopo Stroke), a multicenter, randomized, controlled trial with pre-test (baseline), post-test, and 12 weeks follow-up assessments based on a novel rehabilitation protocol based on the combination of brain stimulation and standard cognitive treatment. In particular, we will compare the efficacy of inhibitory repetitive-transcranial magnetic stimulation (r-TMS), applied over the left intact parietal cortex of LHN patients, followed by visual scanning treatment, in comparison with a placebo stimulation (SHAM control) followed by the same visual scanning treatment, on visuospatial symptoms and neurophysiological parameters of LHN in a population of stroke patients. Discussion Our trial results may provide scientific evidence of a new, relatively low-cost rehabilitation protocol for the treatment of LHN. Trial registration ClinicalTrials.gov NCT04080999. Registered on September 2019.


2020 ◽  
Vol 47 (4) ◽  
pp. 427-434
Author(s):  
Mohammed S. El-Tamawy ◽  
Moshera H. Darwish ◽  
Saly H. Elkholy ◽  
Engy BadrEldin S. Moustafa ◽  
Shimaa T. Abulkassem ◽  
...  

BACKGROUND: Cortical reorganization between both cerebral hemispheres plays an important role in regaining the affected upper extremity motor function post-stroke. OBJECTIVES: The purpose of the current study was to investigate the recommended number of contra-lesion low frequency repetitive transcranial magnetic stimulation (LF-rTMS) sessions that could enhance cortical reorganization post-stroke. METHODS: Forty patients with right hemiparetic subacute ischemic stroke with an age range between 50–65 yrs were randomly assigned into two equal groups: control (GA) and study (GB) groups. Both groups were treated with a selected physical therapy program for the upper limb. Sham and real contra-lesion LF-rTMS was conducted for both groups daily for two consecutive weeks. Sequential changes of cortical excitability were calculated by the end of each session. RESULTS: The significant enhancement in the cortical excitability was observed at the fourth session in favor of the study group (GB). Sequential rate of change in cortical excitability was significant for the first eight sessions. From the ninth session onwards, no difference could be detected between groups. CONCLUSION: The pattern of recovery after stroke is extensive and not all factors could be controlled. Application of LF-rTMS in conjugation with a selected physical therapy program for the upper limb from four to eight sessions seems to be efficient.


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