The Antidepressant Effects of rTMS After Ischemic Stroke
The Antidepressant Effects of rTMS After Ischemic Stroke
This is a multicenter, randomized, double-blind, placebo-controlled trial aims to assess the
 effectiveness of repetitive transcranial magnetic stimulation(rTMS) in treating depression
 after basal ganglia ischemic stroke and to examine whether such effects are related to
 restoration of white matter integrity.Sixty-six participants will be recruited from three
 centers and randomized with a 1:1 ratio to receive active rTMS treatment or sham rTMS
 treatment in addition to routine supportive treatments.The data of neuropsychological tests
 and MRI will be collected at 0, 2 and 4 weeks after the commencement of the treatment.
This is a multicenter, randomized, double-blind, placebo-controlled trial aims to assess the
 effectiveness of rTMS in treating depression after basal ganglia ischemic stroke and to
 examine whether such effects are related to restoration of white matter integrity.Sixty-six
 participants will be recruited from three centers and randomized with a 1:1 ratio to receive
 active rTMS treatment or sham rTMS treatment in addition to routine supportive treatments.The
 data of neuropsychological tests and MRI will be collected at 0, 2 and 4 weeks after the
 commencement of the treatment.The primary outcome is the measurement of 24-item Hamilton
 Depression Rating Scale (HAMD-24) scores, and the secondary outcomes include diffusion tensor
 imaging (DTI) results and the results of neuropsychological tests including National
 Institutes of Health Stroke Scale (NIHSS), Activities of Daily Living Scale (ADLs), Montreal
 Cognitive Assessment (MoCA),Clinical Global Impressions scales(CGI), Aphasia Battery in
 Chinese (ABC), Social Support Revalued Scale (SSRS) and Medical Coping Questionnaire (MCMQ).
Inclusion Criteria:

 1. First-time ischemic stroke with clinical and MRI or CT findings of basal ganglia
 ischemic stroke and a diagnosis of depression due to stroke based on The Diagnostic
 and Statistical Manual of Mental Disorders-IV (DSM-IV) and The International
 Classification of Diseases-10 (ICD-10-CM code 293.83[F06.32]);

 2. Aged 25-75 years with a recent (from 3 weeks to 3 months) ischemic stroke;

 3. Clear signs of neurological deficits in the acute phase;

 4. Clear consciousness;

 5. Right-handedness.

 Exclusion Criteria:

 1. Aphasia or severe cognitive impairment, severe hearing impairment, or severe language
 comprehension deficits due to other causes;

 2. Other cerebral diseases such as Parkinson's disease, encephalitis, dementia, multiple
 sclerosis, head injury, ect.;

 3. Severe systemic disease or ongoing neoplasia;

 4. Ongoing post-operative recovery;

 5. Prior history of depressive disorders or major trauma within 1 year, severe depression
 or any other severe mental disorders;

 6. Current or prior antidepressant use for any reason;

 7. Addiction to drugs, alcohol or other substances;

 8. Contraindications of MRI scan and rTMS treatment such as pacemaker implantation, a
 history of epilepsy, major head trauma, and seizures, ect;

 9. Pregnant or breast-feeding women;

 10. Participation in other clinical research projects;

 11. Refusal to sign informed consent of this study.