Efficacy of theta burst stimulation in treatment of stroke-related insomnia / 中风与神经疾病杂志

ABSTRACT

@#Objective To investigate the therapeutic effect of continuous theta burst stimulation (cTBS) for stroke-related insomnia. Methods Sixty patients with subacute cerebral infarction were evaluated for sleep disorders using the Pittsburgh Sleep Quality Index (PSQI,global score>7 indicating sleep disturbances). They were divided randomly into drug therapy group and combined treatment group. The drug treatment group was given zolpidem 10 mg orally,and the combined treatment group was given oral zolpidem 5 mg plus cTBS to the right dorsolateral prefrontal lobe and parieto-occipital region. The efficacy of cTBS for stroke-related insomnia was determined by comparing the two groups in terms of time to zolpidem withdrawal,zolpidem withdrawal rate within two weeks,PSQI score reduction rate,and the changes of National Institutes of Health Stroke Scale (NIHSS) score,Hamilton Depression Scale (HAMD) score,and Hamilton Anxiety Scale (HAMA) score. Results Compared with the drug treatment group,the combined treatment group showed a significantly shorter time to zolpidem withdrawal and a significantly higher zolpidem withdrawal rate within two weeks(P<0.05). For both groups,NIHSS,HAMD,and HAMA scores improved with the course of treatment,without significant differences between the two groups at the same follow-up time. However,the interaction P-value was statistically significant,which indicated that HAMD and HAMA scores of the two groups would differ over time. Conclusion cTBS has significant benefits in the treatment of stroke-related insomnia,moderately improving patients'anxiety and depression.