Repetitive Transcranial Magnetic Stimulation in Cardiac Autonomic Dysfunction

The Effect of Repetitive Transcranial Magnetic Stimulation on Cardiac Autonomic Dysfunction in Patients With Stroke

The aim of this study is to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) added to conventional neurological rehabilitation on heart rate variability (HRV), quality of life, upper extremity muscle strength and autonomic symptoms in patients with stroke.

Stroke is a leading cause of disability worldwide and is frequently associated with autonomic dysfunction (AD). AD can affect heart function, arterial blood pressure, fluid balance, and other body systems, negatively influencing clinical outcomes and prognosis. Brain damage in cortical and subcortical regions during stroke can disrupt the integrity of the central autonomic network, leading to AD. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method thought to support neuroplasticity and potentially improve autonomic function. This study aims to investigate the effects of rTMS on autonomic dysfunction and related functional parameters in patients with stroke.

Inclusion Criteria:

• Participants aged 35-80 years admitted to the Afyonkarahisar Health Sciences University Hospital Physical Medicine and Rehabilitation Unit for neurological rehabilitation after stroke
• Participants with a history of stroke of at least 3 months
• Neurologically and medically stable participants willing to participate regularly in the study
• Participants capable of following commands

Exclusion Criteria:

• Serious cardiac disease, uncontrolled hypertension
• Epilepsy or history of antiepileptic drug use
• Intracranial metallic implants
• Inner ear implants
• Malignancy
• Active infection
• Skin infection or open wound in the intervention area
• Brain lesions or medications that may alter the seizure threshold
• Increased intracranial pressure
• Uncontrolled migraine
• Fracture or surgery on the hemiplegic side within the last 6 months
• Pregnancy