Activation changes in patients with post-stroke cognitive impairment receiving intermittent theta burst stimulation: A functional near-infrared spectroscopy study.
Hong Yu, Beisi Zheng, Youmei Zhang and 8 others
PMID 38905062WHAT IT FOUND
In adults with post-stroke cognitive impairment, adding intermittent theta burst stimulation to 30 cognitive training sessions showed greater gains in cognition and daily independence than cognitive training alone.
The brain stimulation group also showed increased activation during a word task.
Key findings
01Activation increased more in the iTBS group than controls in channels 32, 37 and 38 during the word task.
02The iTBS group improved more than controls in total LOTCA score, visuomotor organization and thinking operations.
03The iTBS group improved more than controls in modified Barthel Index.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was small: 44 patients were enrolled, the planned sample was 22 per group, and 19 in each group were analysed. There was no sham or placebo stimulation group, so bias from expectation and extra contact cannot be ruled out. The study had no follow-up, so long-term effects are unknown. The cognitive measure used, Loewenstein Occupational Therapy Cognitive Assessment, did not provide memory information. Functional near-infrared spectroscopy could not measure remote brain regions beyond the channels used. The paper notes a lack of consensus about the stimulation protocol for post-stroke cognitive impairment.
The easy way to misread this
Do not conclude that theta burst stimulation alone caused the improvements. Both groups received 30 cognitive training sessions, and the trial had no sham stimulation group, so the added effect of stimulation cannot be separated from training and expectation effects.