Role of Repetitive Transcranial Magnetic Stimulation in Cognitive Rehabilitation in Egyptian Multiple Sclerosis Patients

Background: Patients with multiple sclerosis (MS) experience cognitive impairment is not entirely comprehended in terms of its pathological basis. The objective of this study was to evaluate the effectiveness of high-frequency repetitive transcranial magnetic stimulation (rTMS) in the cognitive rehabilitation of Egyptian patients with multiple sclerosis who are experiencing cognitive impairment. Patients and Methods: This single-cohort prospective, interventional study was performed on 24 patients with MS at Al-Azhar University Hospitals (Al-Hussein and Bab-Elshaarya University Hospitals). Utilizing the symbol digit modalities test (SDMT), all patients underwent a comprehensive medical and neurological history, a full general and neurological examination, a comprehensive examination and investigation for MS patients in accordance with McDonald criteria, a clinical evaluation and scaling, and a cognitive impairment screening within the recruited population. Results: The three scores exhibited a significant difference in the Montreal cognitive assessment (MoCA) (P value= 0.001); MoCA was significantly lower in the first scores than 2ndscores and third scores (P value= 0.015 and 0.001) and was insignificantly different between the second scores and third scores. Beck's first score was with a median (IQR) of 13 (10-15), and the SDMT of 1stscores was with a median (IQR) of 26 (17.75 -33). Conclusions: Our study provides preliminary evidence for the potential of high-frequency rTMS as a cognitive rehabilitation tool in MS patients. The observed improvements in MoCA scores suggest that rTMS may have beneficial effects on overall cognitive function. Nevertheless, additional research is required to verify these results and to identify the cognitive domains that are most responsive to rTMS intervention in MS populations.