Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Donepezil in the Treatment of Mild Post-Stroke Cognitive Impairment
Objective To investigate the clinical efficacy of repetitive transcranial magnetic stimulation combined with donepezil in the treatment of patients with mild post-stroke cognitive impairment(PSCI),and its effect on brain nerve metabolites and inflammatory factors.Methods A total of 145 patients with PSCI admitted to the hospital from January 2020 to October 2023 were selected and divided into the control group(70 cases)and the observation group(75 cases)according to different treatment plans.The patients in the two groups were treated with donepezil,on this basis,the patients in the observation group were treated with repetitive transcranial magnetic stimulation.Both groups were treated for 4 weeks.Results The total effective rate in the observation group was 84.00%,which was significantly higher than 64.29% in the control group(P<0.05).After treatment,the levels of brain nerve metabolites[acetylcholine(ACh),serum norepinephrine(NE),ratio of N-acetylaspartate(NAA)to contralateral NAA in brain tissue],cognitive function[Mini-Mental State Examination Scale(MMSE),Montreal Cognitive Assessment Scale(MoCA),Rivermead Behavioral Memory Test(RBMT)]scores,and ability of daily living[Modified Barthel Index(MBI),Functional Independence Measure(FIM)]in the two groups significantly increased(P<0.05),while the affected side lactate/contralateral creatine complex(Lac/Cr),inflammatory factors[serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),blood homocysteine(Hcy),and C-reactive protein(CRP)]levels in the two groups significantly decreased(P<0.05),and the above indexes in the observation group were significantly better than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 8.00%,which was significantly lower than 20.00% in the control group(P<0.05).Conclusion Repeated transcranial magnetic stimulation combined with donepezil has good clinical efficacy and safety in the treatment of mild PSCI,which can improve cognitive function,increase brain nerve metabolite levels and ability of daily living,reduce inflammatory factor levels,and promote prognosis.
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