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CLINICAL TRIAL article
Front. Neurol.
Sec. Neurorehabilitation
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1513131
Repetitive transcranial magnetic stimulation elevates the serum levels of neurotrophic factors, serotonin and their metabolites in patients with ischemic stroke
Provisionally accepted- Shanxi Medical University, Taiyuan, Shanxi Province, China
Objectives: Repetitive transcranial magnetic stimulation (rTMS) can effectively treat cognitive impairment in stroke patients; however, its mechanism of action remains to be clarified. The aim of this study was to investigate whether rTMS improves cognitive function by regulating levels of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), 5-hydroxytryptamine (5-HT), and 5-hydroxyindoleacetic acid (5-HIAA).Methods: In a 4-week study, 70 patients with ischemic stroke were randomly assigned into two groups to receive rTMS (n = 35) and sham-stimulation (n = 35) in addition to conventional medication and rehabilitation training. Patients in the rTMS group were treated with rTMS at 10 Hz for 20 min per session. The Montreal Cognitive Assessment Scale (MoCA) and response time in the N-back task were used to rate the severity of the disease. Fasting venous blood was collected early in the morning before and after treatment. The peripheral blood levels of BDNF, NGF, 5-HT and 5-HIAA were measured using an enzyme-linked immunosorbent assay (ELISA).Results: The levels of BDNF and NGF were higher in the rTMS group than in the sham group (p = 0.017, p = 0.008) after rTMS treatment, and the levels of 5-HT and 5-HIAA were also elevated in the rTMS group (p = 0.049, p = 0.004). Changes in serum 5-HT and 5-HIAA levels after rTMS treatment correlated with changes in MoCA and response time in the n-back task. There was a positive correlation between the serum 5-HT and BDNF levels (r= 0.4034).Conclusions: Our results showed that BDNF, NGF, 5-HT and 5-HIAA levels were upregulated after rTMS treatment, which likely contributed to improving cognitive function and quality of life in patients with stroke.
Keywords: Author Contributions: Conceptualization, WL and JW, methodology, WL and YW, software, WL and WL, validation, YW and JW, formal analysis, WL, WL and YW, investigation, WL, WL and YW, resources, SY, data curation, YW and JW
Received: 21 Oct 2024; Accepted: 17 Feb 2025.
Copyright: © 2025 Li, Li, Wu and Wen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Junying Wu, Shanxi Medical University, Taiyuan, 030001, Shanxi Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.