Clinical study of repetitive transcranial magnetic stimulation in the rehabilitation of post-stroke depression: A Quantitative Insomnia Sleep Inventory monitoring evaluation

BACKGROUND Jiaxing Hospital of Traditional Chinese Medicine introduced transcranial magnetic stimulation (TMS) technology in 2019. In practical application, it was found that different types of equipment and technical parameters could lead to differences in therapeutic effects. Therefore, our hospital selected a Danish-made TMS device, which ranked second in the Chinese market, and conducted tests on patients with post-stroke depression (PSD) from March 2019 to September 2023. Before the test, a plan was formulated based on the quality status before and after the inspection. Two evaluators independently controlled the quality of the plan. The repetitive TMS (rTMS) and Quantitative Insomnia Sleep Inventory (QUISI) data were separately stored and verified independently by the two evaluators. AIM To investigate the effect of rTMS and QUISI on the sleep and rehabilitation of patients with PSD. METHODS From March 2019 to December 2023, subjects who were admitted to the Department of Rehabilitation of the Jiaxing Hospital of Traditional Chinese Medicine, Shanghai Mental Health Center, and National Medical Centre for Psychiatric Disorders were enrolled. A total of 108 patients with PSD were enrolled: 54 patients in the observation group and 54 in the control group. Sixty-eight normal volunteers were also included. Both the observation group and the control group received venlafaxine 150 mg/day sustained-release therapy. The observation group was given venlafaxine combined with rTMS. The control group was treated with venlafaxine combined with rTMS pseudo stimulation. The two groups underwent 42 treatment sessions over 14 weeks. The Hamilton Depression Rating Scale-17 scores were compared between the two groups before and after treatment, and the changes in QUISI were compared with healthy volunteers. RESULTS The Hamilton Depression Rating Scale-17 scores in the two groups were significantly reduced after treatment, and the improvement was more significant in the observation group (P < 0.05). Before treatment, the sleep latency in the two groups of patients by QUISI was delayed compared to normal volunteers, and the sleep efficiency and maintenance rate were lower than those in normal volunteers, with statistical significance (P < 0.05-0.01). After 14 weeks of treatment, the sleep latency period in the observation group QUISI shifted forward, indicating an increase in sleep efficiency and maintenance rate. The differences between the observation group and the control group were statistically significant (P < 0.01). After a 3-month rehabilitation evaluation, the total effective rate of patients in the observation group was significantly higher than that in the control group (P < 0.05). CONCLUSION rTMS treatment has a positive effect on PSD in clinical practice. QUISI monitoring can be used for rehabilitation assessment.