PTOTSLPRCTNeurorehabilitation and neural repair2024

High-Frequency rTMS Broadly Ameliorates Working Memory and Cognitive Symptoms in Stroke Patients: A Randomized Controlled Trial.

Yuanwen Liu, Yinan Ai, Jie Cao and 9 others

PMID 39162240

WHAT IT FOUND

Stroke patients receiving high-frequency rTMS over the left prefrontal cortex for two weeks showed significantly better working memory scores than those receiving sham stimulation.

These improvements in memory, attention, and daily living tasks persisted for four weeks after treatment ended.

Key findings

01Active rTMS significantly improved working memory performance on 0-, 1-, 2-, and 3-back tasks at week 2 and week 6 compared to sham.

02Secondary outcomes showed significant improvements in global cognition (MMSE, MoCA), instrumental activities of daily living, and executive function measures in the active group.

03Adverse events were similar between groups, with headache being most common, and no seizures occurred.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study was conducted at a single center in China, so results may not generalize to other populations or healthcare systems. Follow-up was limited to 4 weeks post-treatment; long-term durability of effects beyond this period is unknown. The sample size, while adequate for the primary outcome, may have been underpowered for some secondary analyses or subgroup comparisons. The exclusion criteria (e.g., severe aphasia, metal implants) limit applicability to patients with those conditions.

Declared interests

The authors declared no conflicts of interest. The study was funded by various Chinese government and university research grants.

The easy way to misread this

Do not assume rTMS improves basic motor function or self-care independence. While working memory and complex daily living tasks (IADL) improved significantly, basic activities of daily living (BADL) scores did not differ between the active and sham groups.

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