Transcranial Magnetic Stimulation and Perioperative Neurocognitive Disorders

The Effects of rTMS on Postoperative Cognitive Function in Patients After Cardiac Surgery

To investigate the impact of rTMS on the incidence of perioperative neurocognitive disorders in patients after after cardiac surgerysurgery. To explore the underlying mechanisms behind the efficacy.

There is a relatively high incidence of perioperative neurocognitive disorders（PND） after surgeries, and the incidence is even higher in the geriatric population undergoing cardiac surgery. Nevertheless, there remains no effective medication or intervention been approved in PND. It has been shown that brain stimulation can improve cognitive function in mild cognitively impaired patients. However, the effects on cognitive function in PND remain uninvestigated.

Inclusion Criteria:

• 1. Age 18 years or older.
• 2. ASA class I - III, patients undergoing elective cardiac surgery(coronary artery bypass grafting, aortic or mitral valve surgery).
• 3. Sign the informed consent.
• 4. Able to complete follow-up visits.

Exclusion Criteria:

• 1. A history of psychopathology and/or taking medication.
• 2. Previous history of neurological disease.
• 3. Severe organic diseases.
• 4. RTMS contraindications (such as a history of epileptic seizures, metal implants near the head).
• 5. Having delirium, assessed by CAM, before surgery.
• 6. Participating in other clinical studies at the time of screening.
• 7. Having a cardiopulmonary arrest and cardiopulmonary resuscitation.
• 8. Having short-term second operation.