To observe the effects of multiple-modular 3D virtual reality technology (3D-VR technology) combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke cognitive impairment.

Total of 96 patients with post-stroke cognitive impairment who were treated in Sichuan Provincial People' s Hospital were selected between July 2018 and July 2021, including 55 males and 41 females with a mean age of (58.89±10.64) years. The enrolled patients were divided into observation group (48 cases) and control group (48 cases) with the random envelope method. The control group was treated with rTMS on the basis of conventional cognitive rehabilitation training while the observation group was combined with multiple-modular 3D-VR technology training on the basis of the control group. After 4 weeks of continuous treatment, the related functional recovery status [Montreal Cognitive Assessment (MoCA), Rivermead Behavioral Memory Test-Ⅱ (RBMT-Ⅱ), Modified Barthel Index (MBI)], auditory event evoked potential P300, serum indicators [brain-derived neurotrophic factor (BDNF), amyloid precursor protein (APP), homocysteine (Hcy)] and hippocampal magnetic resonance spectroscopy (MRS) metabolites [N-acetyl-aspartic acid (NAA)/creatine (Cr), choline compound (Cho)/Cr] were compared between the two groups of patients.

After treatment, the scores of scales such as MoCA, RBMT-Ⅱ and MBI in the two groups were all increased when compared with those before treatment (all P＜0.05), and the MoCA score (24.68±4.26 vs 22.19±4.05), RBMT-Ⅱscore (18.65±2.37 vs 16.28±2.21) and MBI score (69.28±9.46 vs 64.37±8.84) were significantly higher in observation group than those in control group (all P＜0.05). After treatment, the P300 latency of the two groups was shortened compared to that before treatment, and the P300 amplitude was enhanced (both P＜0.05), and the P300 latency in observation group was significantly shorter than that in control group [(345.45±41.27) vs (379.72±44.34) ms, P＜0.05], and the P300 amplitude was significantly higher than that in control group [(10.69±3.28) vs (7.55±2.84) μV, P＜0.05]. After treatment, the level of serum BDNF in the two groups was enhanced compared with that before treatment while the levels of APP and Hcy were reduced (all P＜0.05), and the level of serum BDNF in observation group was significantly higher than that in control group while the levels of APP and Hcy were significantly lower (all P＜0.05). After treatment, the NAA/Cr values of the left and right sides of the two groups were higher while the Cho/Cr values were lower than those before treatment (all P＜0.05), and the NAA/Cr values of the left and right sides in observation group were significantly higher than those in control group (both P＜0.05).

Multiple-modular 3D-VR technology combined with rTMS therapy can effectively improve the cognitive function, memory function and ability of daily living in patients with post-stroke cognitive impairment. And its mechanism may be related to the improvement of auditory event evoked potential P300 and the regulations of serum BDNF, APP and Hcy metabolisms and hippocampal brain tissue metabolism.