Repetitive transcranial magnetic stimulation improves consciousness disturbance in stroke patients: A quantitative electroencephalography spectral power analysis

摘要

Repetitive transcranial magnetic stimulation is a noninvasive treatment technique that can directly alter cortical excitability and improve cerebral functional activity in unconscious patients. To investigate the effects and the electrophysiological changes of repetitive transcranial magnetic stimulation cortical treatment, 10 stroke patients with non-severe brainstem lesions and with disturbance of consciousness were treated with repetitive transcranial magnetic stimulation. A quantitative electroencephalography spectral power analysis was also performed. The absolute power in the alpha band was increased immediately after the first repetitive transcranial magnetic stimulation treatment, and the energy was reduced in the delta band. The alpha band relative power values slightly decreased at 1 day post-treatment, then increased and reached a stable level at 2 weeks post-treatment. Glasgow Coma Score and JFK Coma Recovery Scale-Revised score were improved. Relative power value in the alpha band was positively related to Glasgow Coma Score and JFK Coma Recovery Scale-Revised score. These data suggest that repetitive transcranial magnetic stimulation is a noninvasive, safe, and effective treatment technology for improving brain functional activity and promoting awakening in unconscious stroke patients. Research Highlights The therapeutic effect of repetitive transcranial magnetic stimulation on the disturbance of consciousness was observed by quantitative electroencephalography spectral power analysis, which can reflect the degree of conscious disturbance through the distribution, power, and amplitude of the spectrum bands. This technique is superior to traditional electroencephalogram in evaluating the effect of magnetic stimulation.Repetitive transcranial magnetic stimulation can alter the excitability of the cerebral cortex and improve the disturbance of consciousness after stroke.The absolute power in the alpha band was increased after repetitive transcranial magnetic stimulation treatment. The relative power value in the alpha band was positively related to Glasgow Coma Score and JFK Coma Recovery Scale-Revised score. Abbreviations rTMS, repetitive transcranial magnetic stimulation; GCS, Glasgow Coma Score; CRS-R, JFK Coma Recovery Scale-Revised