ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurorehabilitation
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1608639
A randomized controlled study on intermittent theta pulse stimulation for improving cognitive impairment after stroke
Provisionally accepted
- Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
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Objective: This study evaluates the efficacy and underlying mechanisms of intermittent theta-burst stimulation (iTBS) in improving cognitive function and quality of life in post-stroke patients. Methods: A total of 80 subacute stroke patients with cognitive deficits were randomly assigned to a control group (n=40) receiving conventional treatment plus sham stimulation and an experimental group (n=40) receiving conventional treatment plus iTBS over the left dorsolateral prefrontal cortex for 4 weeks. Results: Baseline characteristics were comparable between groups. After three months, the experimental group demonstrated significantly greater improvements than the control group in scores for the Mini-Mental State Examination (MMSE; adjusted mean: 25.35 vs. 20.44, P<0.001), Montreal Cognitive Assessment (MoCA; 26.49 vs. 24.57, P=0.002), and Stroke-Specific Quality of Life (SS-QOL; 158.45 vs. 137.31, P<0.001), and showed greater reduction in completion time for the Trail Making Test (TMT). Biochemically, the iTBS group exhibited significantly increased serum Brain-Derived Neurotrophic Factor (BDNF) and reduced levels of Tumor Necrosis Factor-alpha (TNF-α) and Interleukin-6 (IL-6) compared to the control group (all P < 0.001). Changes in BDNF levels correlated positively with improvements in MMSE scores (r=0.58, P<0.001). Conclusion: iTBS is a safe and effective intervention that enhances cognitive recovery and quality of life in post-stroke patients. These benefits are associated with modulation of neuroplasticity and inflammatory markers, suggesting that iTBS may promote recovery by upregulating BDNF and attenuating neuroinflammation. Further research is needed to confirm these mechanisms.
Keywords: Intermittent theta-burst stimulation (iTBS), Stroke, cognitive dysfunction, Neurorehabilitation, Quality of Life
Received: 03 Jun 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Li, Hu, Liang, Liang, Tan and Xing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sisi Xing, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
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