Research Article | | Peer-Reviewed

Continuous Theta Burst Transcranial Magnetic Stimulation in Treating Post-Stroke Insomnia Monitored by Polysomnography: A Case Report

Received: 8 October 2023     Accepted: 26 October 2023     Published: 9 November 2023
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Abstract

The incidence of stroke has been increasing in recent years, and post-stroke insomnia, a common complication, also bothers many stroke patients. Post-stroke insomnia not only affects the quality of sleep and daily functioning of stroke patients, but it can also impacts stroke recovery and potentially lead to anxiety and depression disorders. This case report presents the case of a 47-year-old man who exhibited symptoms of early awakening, easy awakening, and daytime fatigue after suffering from a hypertensive cerebral hemorrhage. These symptoms occurred more than three times per week and persisted for six months. After giving treatments such as acupuncture and medication, this patient's sleep quality did not significantly improve. Considering the availability of noninvasive brain stimulation techniques, we opted to utilize continuous theta burst stimulation for the patient’s treatment. The stimulation was administered to the dorsolateral right frontal lobe, with an intensity set at 30% of resting motor thresholds. The treatment spanned 10 days, with one session per day lasting 48seconds. Following a single session, the patient's sleep quality and sleep structure showed improvement, and he did not experience any discomfort during this treatment. In conclusion, continuous theta burst stimulation proves to be an effective and safe therapeutic approach for patients with post-stroke insomnia.

Published in Clinical Neurology and Neuroscience (Volume 7, Issue 4)
DOI 10.11648/j.cnn.20230704.12
Page(s) 82-85
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Post-Stroke Insomnia, Continuous Theta Burst Stimulation, Polysomnography

References
[1] BAYLAN S, GRIFFITHS S, GRANT N, et al. Incidence and prevalence of post-stroke insomnia: A systematic review and meta-analysis [J]. Sleep medicine reviews, 2020, 49: 101222.
[2] BAGLIONI C, NISSEN C, SCHWEINOCH A, et al. Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis [J]. PloS one, 2016, 11 (3): e0148496.
[3] HALE E, GOTTLIEB E, USSEGLIO J, et al. Post-stroke sleep disturbance and recurrent cardiovascular and cerebrovascular events: A systematic review and meta-analysis [J]. Sleep medicine, 2023, 104: 29-41.
[4] BUDHIRAJA R, ROTH T, HUDGEL D W, et al. Prevalence and polysomnographic correlates of insomnia comorbid with medical disorders [J]. Sleep, 2011, 34 (7): 859-67.
[5] DE CRESCENZO F, D'ALò G L, OSTINELLI E G, et al. Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis [J]. Lancet (London, England), 2022, 400 (10347): 170-84.
[6] HERRERO BABILONI A, BELLEMARE A, BEETZ G, et al. The effects of non-invasive brain stimulation on sleep disturbances among different neurological and neuropsychiatric conditions: A systematic review [J]. Sleep medicine reviews, 2021, 55: 101381.
[7] Yang LY, Lai JH, Cai YF, et al. Effects of repetitive transcranial magnetic stimulation on sleep quality in patients with sleep disorder after stroke: systematic review and meta-analysis. [J]. Chinese Primary Medicine, 2021, 28 (12): 1803-1808.
[8] MA H, LIN J, HE J, et al. Effectiveness of TES and rTMS for the Treatment of Insomnia: Meta-Analysis and Meta-Regression of Randomized Sham-Controlled Trials [J]. Frontiers in psychiatry, 2021, 12: 744475.
[9] MCCARTER S J, HAGEN P T, ST LOUIS E K, et al. Physiological markers of sleep quality: A scoping review [J]. Sleep medicine reviews, 2022, 64: 101657.
[10] RIEMANN D, SPIEGELHALDER K, FEIGE B, et al. The hyperarousal model of insomnia: a review of the concept and its evidence [J]. Sleep medicine reviews, 2010, 14 (1): 19-31.
[11] HEIN M, SENTERRE C, LANQUART J P, et al. Hyperarousal during sleep in untreated primary insomnia sufferers: A polysomnographic study [J]. Psychiatry Res, 2017, 253: 71-8.
[12] HUANG L, ZHOU J, SUN Y, et al. Polysomnographically determined sleep and body mass index in patients with insomnia [J]. Psychiatry Res, 2013, 209 (3): 540-4.
[13] AHMED S, MENG H, LIU T, et al. Ischemic stroke selectively inhibits REM sleep of rats [J]. Exp Neurol, 2011, 232 (2): 168-75.
[14] SUN N, HE Y, WANG Z, et al. The effect of repetitive transcranial magnetic stimulation for insomnia: a systematic review and meta-analysis [J]. Sleep medicine, 2021, 77: 226-37.
[15] JIANG C G, ZHANG T, YUE F G, et al. Efficacy of repetitive transcranial magnetic stimulation in the treatment of patients with chronic primary insomnia [J]. Cell biochemistry and biophysics, 2013, 67 (1): 169-73.
[16] GEISER T, HERTENSTEIN E, FEHéR K, et al. Targeting Arousal and Sleep through Noninvasive Brain Stimulation to Improve Mental Health [J]. Neuropsychobiology, 2020, 79 (4-5): 284-92.
[17] HE W, RUAN Y. Poor sleep quality, vitamin D deficiency and depression in the stroke population: A cohort study [J]. Journal of affective disorders, 2022, 308: 199-204.
[18] SHEN X, LIU M, CHENG Y, et al. Repetitive transcranial magnetic stimulation for the treatment of post-stroke depression: A systematic review and meta-analysis of randomized controlled clinical trials [J]. Journal of affective disorders, 2017, 211: 65-74.
[19] ZHOU L, WANG T, YU Y, et al. The etiology of poststroke-depression: a hypothesis involving HPA axis [J]. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 2022, 151: 113146.
[20] CASTRO L S, CASTRO J, HOEXTER M Q, et al. Depressive symptoms and sleep: a population-based polysomnographic study [J]. Psychiatry Res, 2013, 210 (3): 906-12.
Cite This Article
  • APA Style

    Zhong, L., Wang, H., Dai, Y., Deng, Y., Cao, Y., et al. (2023). Continuous Theta Burst Transcranial Magnetic Stimulation in Treating Post-Stroke Insomnia Monitored by Polysomnography: A Case Report. Clinical Neurology and Neuroscience, 7(4), 82-85. https://doi.org/10.11648/j.cnn.20230704.12

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    ACS Style

    Zhong, L.; Wang, H.; Dai, Y.; Deng, Y.; Cao, Y., et al. Continuous Theta Burst Transcranial Magnetic Stimulation in Treating Post-Stroke Insomnia Monitored by Polysomnography: A Case Report. Clin. Neurol. Neurosci. 2023, 7(4), 82-85. doi: 10.11648/j.cnn.20230704.12

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    AMA Style

    Zhong L, Wang H, Dai Y, Deng Y, Cao Y, et al. Continuous Theta Burst Transcranial Magnetic Stimulation in Treating Post-Stroke Insomnia Monitored by Polysomnography: A Case Report. Clin Neurol Neurosci. 2023;7(4):82-85. doi: 10.11648/j.cnn.20230704.12

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  • @article{10.11648/j.cnn.20230704.12,
      author = {Li-min Zhong and Hong Wang and Yan-hong Dai and Yue-ting Deng and Yi-qi Cao and Ke-yi Chen and Gang Wang},
      title = {Continuous Theta Burst Transcranial Magnetic Stimulation in Treating Post-Stroke Insomnia Monitored by Polysomnography: A Case Report},
      journal = {Clinical Neurology and Neuroscience},
      volume = {7},
      number = {4},
      pages = {82-85},
      doi = {10.11648/j.cnn.20230704.12},
      url = {https://doi.org/10.11648/j.cnn.20230704.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20230704.12},
      abstract = {The incidence of stroke has been increasing in recent years, and post-stroke insomnia, a common complication, also bothers many stroke patients. Post-stroke insomnia not only affects the quality of sleep and daily functioning of stroke patients, but it can also impacts stroke recovery and potentially lead to anxiety and depression disorders. This case report presents the case of a 47-year-old man who exhibited symptoms of early awakening, easy awakening, and daytime fatigue after suffering from a hypertensive cerebral hemorrhage. These symptoms occurred more than three times per week and persisted for six months. After giving treatments such as acupuncture and medication, this patient's sleep quality did not significantly improve. Considering the availability of noninvasive brain stimulation techniques, we opted to utilize continuous theta burst stimulation for the patient’s treatment. The stimulation was administered to the dorsolateral right frontal lobe, with an intensity set at 30% of resting motor thresholds. The treatment spanned 10 days, with one session per day lasting 48seconds. Following a single session, the patient's sleep quality and sleep structure showed improvement, and he did not experience any discomfort during this treatment. In conclusion, continuous theta burst stimulation proves to be an effective and safe therapeutic approach for patients with post-stroke insomnia.
    },
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Continuous Theta Burst Transcranial Magnetic Stimulation in Treating Post-Stroke Insomnia Monitored by Polysomnography: A Case Report
    AU  - Li-min Zhong
    AU  - Hong Wang
    AU  - Yan-hong Dai
    AU  - Yue-ting Deng
    AU  - Yi-qi Cao
    AU  - Ke-yi Chen
    AU  - Gang Wang
    Y1  - 2023/11/09
    PY  - 2023
    N1  - https://doi.org/10.11648/j.cnn.20230704.12
    DO  - 10.11648/j.cnn.20230704.12
    T2  - Clinical Neurology and Neuroscience
    JF  - Clinical Neurology and Neuroscience
    JO  - Clinical Neurology and Neuroscience
    SP  - 82
    EP  - 85
    PB  - Science Publishing Group
    SN  - 2578-8930
    UR  - https://doi.org/10.11648/j.cnn.20230704.12
    AB  - The incidence of stroke has been increasing in recent years, and post-stroke insomnia, a common complication, also bothers many stroke patients. Post-stroke insomnia not only affects the quality of sleep and daily functioning of stroke patients, but it can also impacts stroke recovery and potentially lead to anxiety and depression disorders. This case report presents the case of a 47-year-old man who exhibited symptoms of early awakening, easy awakening, and daytime fatigue after suffering from a hypertensive cerebral hemorrhage. These symptoms occurred more than three times per week and persisted for six months. After giving treatments such as acupuncture and medication, this patient's sleep quality did not significantly improve. Considering the availability of noninvasive brain stimulation techniques, we opted to utilize continuous theta burst stimulation for the patient’s treatment. The stimulation was administered to the dorsolateral right frontal lobe, with an intensity set at 30% of resting motor thresholds. The treatment spanned 10 days, with one session per day lasting 48seconds. Following a single session, the patient's sleep quality and sleep structure showed improvement, and he did not experience any discomfort during this treatment. In conclusion, continuous theta burst stimulation proves to be an effective and safe therapeutic approach for patients with post-stroke insomnia.
    
    VL  - 7
    IS  - 4
    ER  - 

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Author Information
  • Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, China; Department of Rehabilitation, Guangzhou Tianhe District Traditional Chinese Medicine Hospital, Guangzhou, China

  • Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Image, Guangzhou Tianhe District Traditional Chinese Medicine Hospital, Guangzhou, China

  • Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, China

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