Study of Repetitive Transcranial Magnetic Stimulation to Improve Brain Function After Surgery in Older Adults with Mild to Moderate Cognitive Impairment

What this Trial Is About

This research aims to evaluate the effects of repetitive transcranial magnetic stimulation rTMS compared to a sham intervention on postoperative neurocognitive function in older patients with preoperative cognitive impairment. Patients with mild cognitive impairment MCI aged 65 years or older, especially those undergoing elective non-cardiac surgery, face increased risks of delayed neurocognitive recovery DNR and postoperative neurocognitive disorder POCD. The study explores rTMS as a potential neurocognitive protective method in this vulnerable population. Participants will be randomly assigned to receive either real or sham rTMS applied to the left dorsolateral prefrontal cortex DLPFC. The treatment involves twice-daily sessions for 5 daysstarting one day before surgery and continuing for four consecutive days after surgery, with no treatment on the surgery day itself. Each session uses an 8 shaped coil at 10 Hz frequency, with 2000 pulses over 20 minutes. During the study, patients will be monitored for neurocognitive function outcomes including the incidence of delayed neurocognitive recovery on day 5 after surgery, delirium within 5 days, and postoperative neurocognitive disorder at 30 and 180 days post-surgery. Assessments include cognitive tests and clinical evaluations, with the study duration covering preoperative through long-term postoperative follow-up to capture neurocognitive changes and recovery patterns.

Repetitive Transcranial Magnetic Stimulation and Postoperative Neurocognitive Recovery