Neural temporal dynamics of negative emotional symptoms after iTBS in patients with stroke: a TMS-EEG study

Abstract

Abstract Background Stroke pathogenesis may be linked with aberrant neural network connections between brain regions and synapses plasticity. Furthermore, depression following a stroke does not arise from dysregulation in a singular brain region but rather from alterations across a “depression network”. While intermittent theta burst stimulation (iTBS) has been shown to alleviate depressive symptoms and modulate brain networks, but the effects of iTBS stimulation of the cerebellum on post-stroke negative emotional symptoms remain unexplored. Transcranial magnetic stimulation-electroencephalography (TMS-EEG) can offer insights into the dynamic mechanisms underlying iTBS treatment in stroke patients. Objectives The study aims to investigate the temporal dynamics of the power spectrum and functional connectivity in post-stroke patients following iTBS over the cerebellum and to determine if iTBS targeting the cerebellum alters negative emotional symptoms in these patients. Methods Twelve subacute stroke patients were enrolled, baseline data, along with clinical characteristics, were documented. Patients underwent iTBS treatment. Resting state EEG data were collected before and after in the initial and concluding iTBS sessions. Analyses were conducted on some indicators. Results Under different periods’ iTBS intervention, in both the Alpha and Beta1 bands, there was a significant difference in the power spectrum and phase synchronization within regions of interest in stroke patients. A significant correlation was observed between phase synchronization and the self-rating depression scale score. Conclusions In different periods, administering iTBS to target the cerebellum influenced the power spectrum, functional connectivity, and negative emotional symptoms in stroke patients.