Analysis of rehabilitation effect of repetitive transcranial magnetic stimulation based on resting⁃state fMRI in post⁃stroke cognitive impairment patients with low thyroid hormone levels
Bibliographic record
Abstract
Objective To evaluate brain plasticity by resting⁃state fMRI (rs⁃fMRI), and to explore the potential neuroendocrine mechanism of repetitive transcranial magnetic stimulation (rTMS) in improving post⁃stroke cognitive impairment (PSCI) in patients with low thyroid hormone (TH) level. Methods A total of 28 patients with PSCI with low TH level who received rehabilitation treatment in Shijiazhuang People's Hospital from August 2020 to December 2021 were randomly divided into rTMS group (n=15) and control group (n=13). Cognitive function was assessed by Montreal Cognitive Scale (MoCA) before and 4 weeks after rTMS, and serum levels of tri⁃iodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) were measured by double antibody sandwich method. rs⁃fMRI was used to calculate the fractional amplitude of low⁃frequency fluctuation (fALFF) and observe the activated brain regions after stimulation. Pearson correlation analysis was used to obtain the distribution of synchronous changes of activated brain areas based on whole⁃brain functional connection strength of hypothalamus and serum TH level in 2 groups. Results After 4 weeks of intervention, compared with control group, MoCA score (F=1163.054, P=0.000), and serum T3 (F=1111.685, P=0.000), T4 (F=847.333, P=0.000), TSH (F=251.316, P=0.000) in rTMS group was increased. In rTMS group, fALFF value increased mainly in posterior cerebellar lobe (t=4.699, P＜0.05), middle frontal gyrus (t=4.356, P＜0.05) and superior frontal gyrus (t=5.675, P＜0.05), while fALFF value decreased in superior temporal gyrus (t=⁃7.874, P＜0.05) and middle temporal gyrus (t=⁃5.776, P＜0.05). The enhanced functional connectivity of the whole brain with bilateral hypothalamus as the region of interest (ROI) and the simultaneous increase of serum T3 and TSH levels were mainly concentrated in the cerebellum, frontal lobe and parahippocampal gyrus. Conclusions rTMS can indirectly affect hypothalamic function through cerebral cortex, increase serum TH level and improve cognitive function in PSCI patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".