重复经颅磁刺激对脑梗死患者脑网络活动的影响:基于图论分析的静息态脑电研究OA

Objective This study aims to explore the effects of high-frequency(HF)and low-frequency(LF)repetitive transcranial magnetic stimulation(rTMS)on upper limb function and brain network activity,as well as the correlation between clinical functional changes and brain network activity.Methods A total of 60 patients with first-onset unilateral ischemic stroke were recruited from the First Affiliated Hospital of Southwest Medical University From January 2022 to March 2023 were randomly allocated into HF-and LF-rTMS groups.For the HF group,10 Hz rTMS was administered to the cortical motor areas of the affected hemisphere.For the LF group,1 Hz was applied to the cortical motor area of the unaffected hemisphere.All participants received 10 daily session of rTMS in consecutive days.Assessments were performed before and after the intervention.Outcomes assessments included stroke severity(NIHSS),upper extremity function(FMA-UE),ADL(MBI),and the brain network activities(functional connectivity,path length and global efficiency)detected via resting state EEG.Differences were compared by paired or independent t-tests with false discovery rate(FDR)correction.Correlation analysis was employed to examine relationships between clinical outcomes and neurophysiological activities.A significant level of P<0.05 was used to determine statistical significance.Results There were no significant differences in all demographic characteristics at baseline between two groups(P>0.05),except for a statistically significant difference in gender between the two groups(P>0.05).After intervention,the FMA-UE score in the LF group was significantly increased compared with that before intervention(P=0.028);NIHSS scores in both groups were significantly decreased compared with those before intervention(both P<0.001).After intervention,there were no statistically significant differences in NIHSS score,FMA-UE score,and MBI between the two groups(all P>0.05).Regarding brain network activity,compared with that before intervention,the HF group showed reduced path length(P=0.04)and increased global efficiency(P=0.03)in the beta2 frequency band;the difference in changes of global efficiency in the beta2 frequency band brain network between the two groups after intervention was statistically significant(P=0.04).Correlation analysis showed that the change in NIHSS score in the HF group was negatively correlated with path length in the beta2 frequency band brain network(r=-0.405,P=0.049).Conclusions LF-rTMS improves upper limb function and reduces the severity of neurological deficits in stroke patients,yet no correlation with alterations in brain networks has been identified.In contrast,HF-rTMS reduces neurological deficits,and this effect is associated with changes in the path length of brain networks triggered by rTMS.