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The purpose of this study is to evaluate the safety and effectiveness of transcranial magnetic stimulation (TMS) therapy in moyamoya patients who received surgical revascularization.
Primary Outcome Measures:
TMS stimulation applied to the left DLPFC has a quantifiable effect on cognition [ Time Frame: Neuropsychological Assessments: Baseline(7days after STA-MCA bypass surgery); 2 months after TMS treatment Changes in one or more assessed cognitive domains at baseline will be measured by comparing the scores for the different neuropsychological tests.
Secondary Outcome Measures:
Change in structural grey and white matter in the brain at baseline compared to after TMS stimulation [ Time Frame: MRI: Baseline and two months after TMS stimulation ] MRI analysis will measure any changes in cortical thickness (mm) or other structural changes in the brain after TMS or Sham-TMS stimulation
Change in executive functioning measured as resting-state functional MRI (fMRI) sequence [ Time Frame: MRI: Baseline and two months after TMS stimulation ] fMRI analysis will measure any changes in amplitude of low frequency fluctuation(ALFF) and other functional changes after TMS stimulation compared to baseline.](streamdown:incomplete-link)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TMS | Experimental | The Transcranial Magnetic Stimulation course consisted of daily sessions of 2,000 stimuli for the left DLPFC (50 trains of 40 stimuli at 10 Hz for 10 days), |
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| SHAM | Sham Comparator | The patient is treated with Sham-TMS stimulation according to protocol with an inactive coil. The sham coil looks and sounds just like the real coil, but produces a negligible magnetic field. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transcranial Magnetic Stimulation | Device | A total of 2000 trains will be delivered successively. The pulses will be delivered at 80% of motor thresholds. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Neurocognitive outcomes at 3 months follow-up after TMS | Measure neurocognitive outcomes using Mini-mental State Examination (MMSE) | 3 months |
| Neurocognitive outcomes at 3 months follow-up after TMS | Measure neurocognitive outcomes using memory and executive screening (MES) | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in structural imaging in the brain at baseline compared to after TMS stimulation | MRI analysis will measure any changes in cortical thickness (mm) in the brain after TMS or Sham-TMS stimulation | 3 months |
| Change in structural imaging in the brain at baseline compared to after TMS stimulation |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D009072 | Moyamoya Disease |
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D002340 | Carotid Artery Diseases |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| ID | Term |
|---|---|
| D050781 | Transcranial Magnetic Stimulation |
| ID | Term |
|---|---|
| D055909 | Magnetic Field Therapy |
| D013812 | Therapeutics |
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| Sham Transcranial Magnetic Stimulation | Device | The sham coil looks and sounds just like the real coil, but produces a negligible magnetic field. |
|
|
MRI analysis will measure any changes in cortical white matter micro-structure (DTI) in the brain after TMS or Sham-TMS stimulation |
| 3 months |
| Change in functional imaging in the brain at baseline compaired to after TMS stimulation | MRI analysis will measure any changes in ALFF in the brain after TMS or Sham-TMS stimulation | 3 month |
| Change in functional imaging in the brain at baseline compaired to after TMS stimulation | MRI analysis will measure any changes in functional connectivity strength in the brain after TMS or Sham-TMS stimulation | 3 month |
| D009422 | Nervous System Diseases |
| D002539 | Cerebral Arterial Diseases |
| D020765 | Intracranial Arterial Diseases |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |