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Effect of Repetitive Transcranial Magnetic Stimulation on Cognition and Mood in Stroke Patients: A Double-Blind, Sham-Controlled Trial

Kim, Bo Ryun MD; Kim, Dae-Yul MD, PhD; Ho Chun, Min MD, PhD; Hwa Yi, Jin MD; Sung Kwon, Jae OT

American Journal of Physical Medicine & Rehabilitation: May 2010 - Volume 89 - Issue 5 - p 362-368
doi: 10.1097/PHM.0b013e3181d8a5b1
Original Research Article: Cognitive

Kim BR, Kim DY, Chun MH, Yi JH, Kwon JS: Effect of repetitive transcranial magnetic stimulation on cognition and mood in stroke patients: A double-blind, sham-controlled trial.

Objective: This study examined whether repetitive transcranial magnetic stimulation applied over the left dorsolateral prefrontal cortex (DLPFC) affected cognition or mood in poststroke patients.

Design: The study was a single-center, prospective, double-blind, sham-controlled preliminary study. Eighteen patients (10 males and 8 females; average age, 62.9 yrs) were enrolled. All participants were randomly assigned to one of three treatment groups: low-frequency (1 Hz) stimulation, high-frequency (10 Hz) stimulation, and sham stimulation (control). Each patient underwent 10 consecutive treatment sessions (five times per week for 2 wks). A Computerized Neuropsychological Test was used to evaluate cognitive function, the Tower of London test was used to assess executive function, the Modified Barthel Index score was used to assess activity of daily living function, and the Beck Depression Inventory was used to assess mood status. These evaluations were conducted in all patients before and after treatment.

Results: Treatment had no significant effect on any cognitive function parameter, including the Tower of London scores, in any of the three groups. In contrast, high-frequency repetitive transcranial magnetic stimulation resulted in significantly lower Beck Depression Inventory scores compared with baseline and compared with the other two groups. The Modified Barthel Index scores significantly increased in all three groups.

Conclusions: These preliminary data suggest that there was a positive effect on mood, but the study was not powered to detect any measurable effect on cognition.

From the Department of Rehabilitation Medicine (BRK, DYK, MHC, JHY), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and Department of Occupational Therapy (JSK), College of Health Sciences, Yonsei University, Wonju, Republic of Korea.

All correspondence and requests for reprints should be addressed to Dae-Yul Kim, Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-gu, 138-736 Seoul, Republic of Korea.

Supported and funded by the Asan Institute for Life Science, Seoul, Korea (Task No.: 2008-454).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2010 Lippincott Williams & Wilkins, Inc.