The effects of repetitive transcranial magnetic stimulation (rTMS) on depression, visual perception, and activities of daily living in stroke patients.
Ko-Un Kim, Soo-Han Kim, Tae-Gyu An
PMID 28626318WHAT IT FOUND
The rTMS group had lower depression scores and higher visual perception and ADL scores over 4 weeks, but the control group also improved by week 8.
All 44 stroke patients with unilateral neglect also received conventional rehabilitation, so rTMS was not shown to work alone.
Key findings
01In the experimental group, depression scores decreased from 25.8 ± 2.3 to 17.2 ± 3.4 at 4 weeks and 15.5 ± 3.3 at 8 weeks; visual perception scores increased from 14.9 ± 6.2 to 24.4 ± 5.1 and 29.0 ± 5.3; and ADL scores increased from 66.6 ± 7.8 to 78.2 ± 6.1 and 79.6 ± 6.4.
02In the control group, there was no difference between week 1 and week 4; by week 8, depression and visual perception improved significantly, but ADL did not.
STILL TO COME
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What it does not show
Only 44 patients were included, and the authors say the results are difficult to generalise. Both groups received conventional rehabilitation focused on visuospatial neglect, and the control group also improved in depression and visual perception, so the contribution of rTMS alone cannot be separated from the rehabilitation programme. The paper reports within-group changes and does not provide a direct between-group comparison for the outcomes. The authors did not investigate other factors that can influence ADLs. Both groups received mock rTMS for weeks 5 to 8, so week 8 results may not reflect the intervention period alone.
The easy way to misread this
Do not conclude that rTMS alone improved depression, visual perception, or ADLs. Both groups received conventional rehabilitation focused on visuospatial neglect, and the control group also improved in depression and visual perception by week 8, so the study does not separate the effect of rTMS from the rehabilitation programme.