| Objective: To observe the differences in the treatment of post-stroke motor aphasia with repeated transcranial magnetic stimulation (rTMS) at different frequencies and stimulation sites. Methods: A total of 99 patients with post-stroke motor aphasia admitted to our hospital were selected as the research subjects and randomly divided into high-frequency group, low-frequency group, and dual stimulation group,with 33 patients in each group. The high-frequency group was stimulated with 10 Hz rTMS to stimulate the left Broca area, and the low-frequency group was stimulated with 1Hz rTMS to stimulate the right Broca mirror area. The dual stimulation group was first given 1 Hz low-frequency stimulation to stimulate the right Broca mirror area, and then received 10 Hz high-frequency stimulation to stimulate the left Broca area every 20 min. All three groups were intervened for 8 weeks. The Boston diagnostic aphasia rating scale (BDAE), Chinese functional communicative competence test (CFCP) score, voice disorder index (VHI), stroke and aphasia quality of life scale (SAQOL-39), as well as the levels of neuron specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) were observed before and after treatment, and the clinical efficacy was evaluated. Results: After 8 weeks of intervention, the BDAE grading of all three groups was better than before intervention (P<0.05). The dual stimulation group was superior to both the high-frequency and low-frequency groups (P<0.05). After 8 weeks of intervention, the CFCP in all three groups was higher than before stimulation (P<0.05), and the VHI was lower than before stimulation (P<0.05). The dual stimulation group had a higher CFCP than the other two groups (P<0.05). The VHI score in the double stimulation group was lower than in the low-frequency group (P<0.05). After 8 weeks of intervention, except for the low-frequency group, the remaining groups had higher levels of BDNF and lower levels of NSE than before stimula-tion (P<0.05). The double stimulation group had lower NSE levels than the other two groups (P<0.05). The level of BDNF in the dual stimulation group was higher than the low-frequency group (P<0.05). After 8 weeks of intervention, except for the psychological dimensions of the low-frequency and high-frequency groups, the scores of the other three groups in all three dimensions of SAQOL-39 were higher than before stimulation (P<0.05). Inter group comparison showed that the dual stimulation group had higher communication and physiological dimensions than the other two groups (P<0.05). In terms of clinical efficacy, the total effective rate of the dual stimulation group was 96.97%, which was significantly higher than the high frequency group and the low frequency group (P<0.05). Conclusion: By comparing the intervention of rTMS on mild and moderate post-stroke motor aphasia with different frequencies and stimulation sites, it was found that the effect of high-frequency rTMS on the left side was equivalent to that of low-frequency rTMS on the right side, and the combined stimulation of the two could enhance the therapeutic effect. |
