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Published in: Acta Neurologica Belgica 1/2024

26-09-2023 | Repetitive Transcranial Magnetic Stimulation | Original article

Effects of repetitive transcranial magnetic stimulation on improving cerebral blood flow in patients with middle cerebral artery steno-occlusion

Authors: Kisoo Pahk, Sang-Hun Lee

Published in: Acta Neurologica Belgica | Issue 1/2024

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Abstract

Background

Repetitive transcranial magnetic stimulation (rTMS) has been reported to induce neurogenesis and angiogenesis. As increased neural activity can induce a hemodynamic response, we investigated the effect of rTMS on perfusion in patients with middle cerebral artery steno-occlusion.

Methods

This was a prospective, randomized, open-label, blinded end-point, pilot study. Patients were divided into two groups (rTMS intervention and non-intervention) which were both administered antiplatelet drugs to treat vascular steno-occlusion. In the intervention group, additional rTMS was performed on the area with stenosis and obstruction. Perfusion rates were compared using single-photon emission computed tomography / computed tomography (SPECT/CT).

Results

From June 2020 to May 2022, 16 patients were subjected to 1:1 randomization. Using the standardized uptake value ratio (SUVr) to quantify perfusion in the affected brain region, the corresponding SPECT/CT values before and after rTMS were obtained. Imaging analysis was compared between eight and seven patients in the rTMS and control groups, respectively. Based on the comparison between the target and ipsilateral cerebellum SUVmeans, four patients had a ≥ 20% increase in SUVr in the rTMS group and none in the control group. Changes in SUVr were significantly different between the initial and follow-up SPECT/CT in the rTMS group (p = 0.033); no significant difference was observed in the control group (p = 0.481).

Conclusion

We observed a significant improvement in perfusion in the stimulation group in a perfusion test performed between 6 and 12 months after rTMS stimulation in stroke patients with steno-occlusion of the middle cerebral artery.
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Metadata
Title
Effects of repetitive transcranial magnetic stimulation on improving cerebral blood flow in patients with middle cerebral artery steno-occlusion
Authors
Kisoo Pahk
Sang-Hun Lee
Publication date
26-09-2023
Publisher
Springer International Publishing
Published in
Acta Neurologica Belgica / Issue 1/2024
Print ISSN: 0300-9009
Electronic ISSN: 2240-2993
DOI
https://doi.org/10.1007/s13760-023-02383-y

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