Exploring the efficacy of repetitive transcranial magnetic stimulation on post-stroke depression patients and changes in cerebral white matter fiber tracts based on diffusion tensor imaging
10.3969/j.issn.1004-1648.2025.04.007
- VernacularTitle:基于弥散张量成像探讨重复经颅磁刺激对脑梗死后抑郁患者的疗效及脑白质纤维束的改变
- Author:
Lili WANG
1
;
Qinyu MA
;
Ruifang REN
Author Information
1. 453100 新乡医学院第一附属医院神经内科
- Publication Type:Journal Article
- Keywords:
post-stroke depression;
DTI;
fractional anisotropy;
repetitive transcranial magnetic stimulation therapy
- From:
Journal of Clinical Neurology
2025;38(4):254-261
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)on post-stroke depression(PSD)patients and changes in cerebral white matter fiber tracts based on diffusion tensor imaging.Methods Thirty patients with PSD were randomly divided into rTMS group(n=15)and sham stimulation group(n=15).Based on conventional treatment for cerebrovascular diseases,the rTMS group was given continuous high-frequency(10 Hz)rTMS for 20 sessions,while the sham stimulation group was given sham stimulation for 20 sessions.The NIHSS score,Hamilton depression scale(HAMD)score,Pittsburgh sleep quality index(PSQI)score,Barthel index(BI),and fractional anisotropy(FA)values of various fiber tracts were compared between the two groups before and after treatment.Fifteen non-depressed patients after stroke who visited during the same period were selected as the control group,and the differences in relevant scale scores and imaging indicators between them and PSD patients were compared.Results There were significant differences in left cortical spinal tract(CST),cingulum and cingulate gyrus(CC)and inferior fronto-occipital fasciculus(IFO)FA values among rTMS group,sham stimulation group and control group before treatment(all P＜0.05).There was no significant difference in the FA value of each fiber bundle between rTMS group and sham stimulation group before treatment(all P＞0.05).After treatment,the FA values of left CST,IFO and uncinate fasciculus(Unc)in the rTMS group were significantly higher than those in the sham stimulation group(all P＜0.05).Compared with those before treatment,the HAMD score,PSQI score,NIHSS score after treatment in the rTMS group and the PSQI score,NIHSS score in the sham stimulation group were significantly decreased,and the BI score in the rTMS group and the sham stimulation group was significantly increased(all P＜0.05).Compared with those in the sham stimulation group,the HAMD score and PSQI score were significantly decreased,and the BI score was significantly increased in the rTMS group after treatment(all P＜0.05).The FA values of left CST,CC and IFO in PSD patients were negatively correlated with HAMD score(r=-0.7211,r=-0.6500,r=-0.7265).Conclusions The microstructure damage of left CST,CC and IFO may be involved in the occurrence of PSD.rTMS can repair the microstructure damage of white matter fiber bundles,thus effectively improving the depression of PSD patients.
