Background: Acute ischemic stroke (AIS) is a prevalent and challenging neurological condition associated with high mortality and morbidity rates. This study aimed to evaluate the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with ginkgo diterpene lactone meglumine injection (GDLMI) on cognitive and neurological function recovery in patients with AIS.
Methods: A total of 120 patients with AIS, admitted between January 2021 and January 2022, received rTMS combined with GDLMI after admission. Their cognitive and neurological functions were assessed using the Chinese version of the Montreal Cognitive Assessment (MoCA) and the National Institute of Health Stroke Scale (NIHSS) respectively before and after treatment. Additionally, serum levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) and ischemia-modified albumin (IMA) were quantified. Statistical analyses were performed to elucidate potential correlations between Lp-PLA2 and IMA levels and clinical outcomes.
Results: After treatment, patients with AIS exhibited significantly improved cognitive and neurological functions, increased MoCA score and decreased NIHSS score compared to those before treatment (p < 0.05). A linear correlation was observed between Lp-PLA2 and IMA levels and the recovery of cognitive function in AIS patients (r = -0.892/-0.764, p < 0.05). Before and after factor adjustment, Lp-PLA2 and IMA were identified as independent influencing factors for the efficiency in cognitive function recovery (p < 0.05). Similarly, Lp-PLA2 and IMA levels were linearly correlated with the recovery of neurological function in AIS patients (r = -0.887/-0.796, p < 0.05). Lp-PLA2 combined with IMA performed better than Lp-PLA2 or IMA alone in predicting the efficiency of rTMS plus GDLMI in promoting the cognitive and neurological function recovery (p < 0.05).
Conclusions: rTMS combined with GDLMI can contribute to the cognitive and neurological function recovery in patients with AIS. Serum levels of Lp-PLA2 and IMA could serve as independent influencing factors for the efficiency in promoting cognitive and neurological function recovery.