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Abstract
Background: Repetitive transcranial magnetic stimulation (rTMS) holds promise as therapeutic tool for cognitive impairment following cerebrovascular stroke. Purpose: The aim of this study was to evaluate the effect of different frequencies of repetitive transcranial magnetic stimulation (rTMS) combined with aerobic exercise on improvement of cognitive functions in chronic stroke patients. Subjects and methods: Thirty right handed stroke patients with right sided hemiparesis of both gender participated in the study. The patients were randomly assigned into three equal groups, group (I): Received (10 Hz) frequency of rTMS combined with aerobic exercise and physiotherapy program, group (II): Received (5Hz) frequency of rTMS combined with the same aerobic exercise and physiotherapy program and group (III): Received the same aerobic exercise and physiotherapy program. All patients were evaluated using addenbrooke,s cognitive examination revised test (ACE-R) for assessment of cognitive functions and transcrinal doppler (TCD) for assessing blood flow velocity in MCApre and post treatment. Results: There was significant improvement in the total score of ACE-R test post treatment in the three groups especially in group (I)) with a percentage of improvement (33.5, 25and 10.1% respectively). Groups (I,II) showed significant improvement of nearly all domains of cognitive functions especially (Memory-recall, Language-repetition and Visuospatial abilities) post treatment. There was significant increase in right and left MCA blood flow velocity within the three groups post treatment and there was a significant difference between the three groups in left MCA blood flow velocity after treatment