Efficacy and safety of low-frequency repetitive transcranial magnetic stimulation in post-stroke depression: A fNIRS pilot study.

AIMS: To evaluate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) on the right dorsolateral prefrontal cortex (DLPFC) in patients with post-stroke depression (PSD), and to explore the possible neural mechanism of repetitive transcranial magnetic stimulation (rTMS) using functional near-infrared spectroscopy (fNIRS).

METHODS

28 patients were randomly assigned to the rTMS group (n = 14) and control group (n = 14). The treatment effect was assessed by the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), National Institutes of Health Stroke Scale (NIHSS), and Barthel Index (BI). In addition, fNIRS was used to detect changes in blood oxygen concentration in the frontal cortex.

RESULTS

After treatment, HAMD scores in the rTMS group decreased significantly more than those in the control group (p < 0.05). Oxyhemoglobin (HbO) in CH17 increased and deoxyhemoglobin (HbR) in CH6 decreased after rTMS (p < 0.05). HbR in CH6 and CH8 decreased significantly, while HbR in CH12 and CH15 increased significantly (p < 0.05). The rTMS group also showed significantly greater improvements in HAMA, NIHSS, and Barthel Index scores (p < 0.05).

CONCLUSION

The findings from this pilot study suggest that LF-rTMS on the right DLPFC combined with conventional treatment may be a safe approach to alleviate depressive symptoms in patients with PSD. Furthermore, fNIRS revealed that the mechanism of action may be related to improving left-right brain tissue blood flow and activation balance.