Efektivitas repetitive transcranial magnetic stimulation terhadap perbaikan fungsi kognitif pasien gangguan kognitif vaskular
https://doi.org/10.22146/bns.v18i3.55022 Baruno Adi Christiantoro(1*), Astuti Astuti(2), Imam Rusdi(3), Kusumo Dananjoyo(4)
(1) KSM Penyakit Saraf, RS Pantirapih, Yogyakarta
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(3) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(4) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author
Abstract
Gangguan kognitif pasca stroke terjadi cukup sering pada pasien stroke. Prevalensi gangguan kognitif pasca stroke bervariasi antara 20-80%. Gangguan kognitif menimbulkan dampak yang ringan hingga berat. Repetitive Transcranial Magnetic Stimulation (rTMS) merupakan metode non-invasif yang dapat menghasilkan perubahan potensial terhadap rangsangan kortikal. Stimulasi rTMS mampu mendorong pemulihan fungsional pada pasien stroke dengan cara menginduksi neuroplastisitas.
Penelitian ini bertujuan untuk mengetahui efektivitas rTMS dalam memperbaiki fungsi kognitif pada pasien gangguan kognitif pasca stroke infark yang dilihat dengan tes Montreal Cognitive Assesment-Indonesia (MoCA-Ina) setelah dilakukan terapi rTMS di regio DLPFC kiri selama 10 sesi.
Sebanyak 38 subjek terbagi dalam kelompok perlakuan rTMS dan kontrol mengikuti penelitian ini dengan rerata usia 58,76+4,8 tahun dan nilai MoCA-Ina 15+7,04. Hasil analisis bivariat didapatkan perlakuan rTMS secara bermakna memperbaiki selisih rerata MoCA-Ina dibandingkan kelompok kontrol baik sesaat (p <0,001) maupun 1 bulan setelah perlakuan (p <0,001). Setelah dilakukan analisis multivariat menunjukkan bahwa hanya perlakuan rTMS yang menjadi faktor independen perbaikan rerata selisih MoCA-Ina baik pada sesaat (p =0,001) maupun 1 bulan setelah perlakuan (p <0,001).
Berdasarkan penelitian ini terapi rTMS memberikan perbaikan signifikan fungsi kognitif global yang dinilai dari skor MoCA-Ina pada pasien gangguan kognitif pasca stroke infark pada sesaat setelah perlakuan rTMS dan bertahan hingga 1 bulan kemudian.
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DOI: https://doi.org/10.22146/bns.v18i3.55022
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