Determination of the effect of repetitive Transcranial Magnetic Stimulation (rTMS) on the primary visual cortex on improving the visual status of patients with subcortical stroke in the area of the posterior cerebral artery

Payam Saadat; Muhammad Abbasi Golmaee; Seyed Ahmad Rasoulinejad; Ali Bijani

doi:10.1016/j.heliyon.2023.e14830

Determination of the effect of repetitive Transcranial Magnetic Stimulation (rTMS) on the primary visual cortex on improving the visual status of patients with subcortical stroke in the area of the posterior cerebral artery

Heliyon. 2023 Mar 23;9(4):e14830. doi: 10.1016/j.heliyon.2023.e14830. eCollection 2023 Apr.

Authors

Payam Saadat^{1

2}, Muhammad Abbasi Golmaee³, Seyed Ahmad Rasoulinejad⁴, Ali Bijani⁵

Affiliations

¹ Associated Professor of Neurology, Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
² Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
³ Graduated from General Medicine, Babol University of Medical Sciences, Iran.
⁴ Associate Professor of vitreo retina, Department of Ophthalmology, Ayatollah Rouhani Hospital, Health Research Institute, Babol University of Medical Sciences, Iran.
⁵ Assistant Professor of Epidemiology (Research-Based), Research Center for Social Factors Affecting Health, Health Research Institute, Babol University of Medical Sciences, Iran.

Abstract

Background and objective: Repetitive Transcranial Magnetic Stimulation (rTMS)-induced neuroplasticity to induce trans-synaptic transmission at a site away from the stimulus site is one of the recent possible strategies for brain rehabilitation in patients with stroke. This study aimed to determine the effect of rTMS on the primary visual cortex of the lesion side of the brain on improving the visual status of patients with subcortical stroke in the posterior cerebral artery.

Methods: After obtaining written consent, this non-randomized clinical trial study was performed on ten eligible patients. The National Eye Institute 25-items Visual Function Questionnaire (NEI-VFQ) and 30-degree automated Perimetry (visual field test) were used to assess patients' vision status before and after ten rTMS sessions. Paired T-test and Student T-test were used to analyze the data using SPSS software.

Findings: A comparison of the mean and standard deviation of the total score of the VFQ-25 for each question did not show a significant difference between pre-test and post-test. In perimetry values based on the Visual Field Index (VFI), the correlation of mean deviation (MD) and the pattern standard deviation (PSD) did not differ significantly before and after the intervention.

Conclusion: According to the results of this study, the rTMS method cannot be reliable as an effective method in the treatment of visual impairment caused by stroke. Therefore, our study does not definitively support rTMS as the first-choice method by physicians for stroke rehabilitation with visual impairment.

Keywords: Ischemic stroke; Neural plasticity; Transcranial magnetic stimulation; Visual field test.