重复经颅磁刺激治疗脑卒中后认知障碍的基础研究进展OA

Post-stroke cognitive impairment(PSCI)is one of the most common and serious functional disorders after stroke.Its pathophysiological mechanism is complex and multifactorial,mainly involving cortical dysfunction,cerebral hypoperfusion,inflammatory response,neurotransmitter imbalance,and microbiota-gut-brain axis disorder.As a non-invasive and painless neuromodulation technique,repetitive transcranial magnetic stimulation(rTMS)has shown great potential in improving cognitive function in patients with PSCI.Basic studies have revealed that rTMS may improve cognitive function by regulating cortical excitability and synaptic plasticity,promoting cerebral blood flow and blood-brain barrier repair,regulating the expression of neurotransmitters and key signaling proteins,and affecting the composition of gut microbiota.However,the unclear specific mechanism and optimal stimulation parameters of rTMS limit its further clinical application in PSCI.This article reviews the pathogenesis of PSCI,the mechanism of rTMS,and the research progress of its basic and clinical application,so as to provide a reference for the clinical application and future research of rTMS in the treatment of PSCI.