Enhancement of glymphatic function and cognition in chronic insomnia using low-frequency rTMS
Bibliographic record
Abstract
STUDY OBJECTIVES: Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) is a promising treatment for chronic insomnia; however, its effectiveness in improving cognitive and glymphatic clearance functions remains unclear. We aimed to investigate the effects of chronic insomnia on glymphatic clearance function and the effectiveness of LF-rTMS on chronic insomnia. METHODS: Thirty-two patients with chronic insomnia and 40 healthy controls underwent baseline assessments of clinical measures and glymphatic functions using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS). Thereafter, 22 patients underwent 10 sessions of LF-rTMS over two consecutive weeks, sleep assessments at week 2 and months 1, 2, and 3, and DTI-ALPS and cognitive-related assessments at week 2 and month 3. RESULTS: Compared to healthy controls, patients showed significant differences in the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Montreal Cognitive Assessment (MoCA) Scale, digit symbol substitution test (DSST), color trail test (CTT), digit span test (DST), Stroop tests, and DTI-ALPS index (all ps < 0.05). After LF-rTMS, patients showed a significant decrease in PSQI and ISI scores from week 2 onwards and significant improvement in MoCA, DSST, DST, CTT-B tests, and DTI-ALPS index by month 3 (all ps < 0.05). Furthermore, the increase in the DTI-ALPS index was significantly associated with improvements in PSQI, ISI, MoCA, and DST-backward at month 3 (r = 0.579, 0.558, 0.836, and 0.642, respectively, and p = 0.038, 0.047, <0.001, and 0.018, respectively). CONCLUSIONS: This study provided preliminary evidence for LF-rTMS' valuable effects on glymphatic clearance and cognitive function in patients with chronic insomnia, which supports LF-rTMS' clinical application in those population. CLINICAL TRIAL INFORMATION: This study has been officially registered with the Chinese Clinical Trial Registry. The trial, titled "Effect of Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Insomnia and the Underlying Brain Mechanism," is accessible via the following URL: https://www.chictr.org.cn/showproj.html?proj=205347. The registration number assigned to this trial is ChiCTR2300077939.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| 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) | 0.000 | 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 teacher head, 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".