Repetitive transcranial magnetic stimulation in Alzheimer’s disease:effects on neural and synaptic rehabilitation

Alzheimer’s disease is a neurodegenerative disease resulting from deficits in synaptic transmission and homeostasis.The Alzheimer’s disease brain tends to be hyperexcitable and hypersynchronized,thereby causing neurodegeneration and ultimately disrupting the operational abilities in daily life,leaving patients incapacitated.Repetitive transcranial magnetic stimulation is a cost-effective,neuro-modulatory technique used for multiple neurological conditions.Over the past two decades,it has been widely used to predict cognitive decline;identify pathophysiological markers;promote neuroplasticity;and assess brain excitability,plasticity,and connectivity.It has also been applied to patients with dementia,because it can yield facilitatory effects on cognition and promote brain recovery after a neurological insult.However,its therapeutic effectiveness at the molecular and synaptic levels has not been elucidated because of a limited number of studies.This study aimed to characterize the neurobiological changes following repetitive transcranial magnetic stimulation treatment,evaluate its effects on synaptic plasticity,and identify the associated mechanisms.This review essentially focuses on changes in the pathology,amyloidogenesis,and clearance pathways,given that amyloid deposition is a major hypothesis in the pathogenesis of Alzheimer’s disease.Apoptotic mechanisms associated with repetitive transcranial magnetic stimulation procedures and different pathways mediating gene transcription,which are closely related to the neural regeneration process,are also highlighted.Finally,we discuss the outcomes of animal studies in which neuroplasticity is modulated and assessed at the structural and functional levels by using repetitive transcranial magnetic stimulation,with the aim to highlight future directions for better clinical translations.

Contribution of glial cells to the neuroprotective effects triggered by repetitive magnetic stimulation:a systematic review

Repetitive transcranial magnetic stimulation has been increasingly studied in different neurological diseases,and although most studies focus on its effects on neuronal cells,the contribution of nonneuronal cells to the improvement trigge red by repetitive transcranial magnetic stimulation in these diseases has been increasingly suggested.To systematically review the effects of repetitive magnetic stimulation on non-neuronal cells two online databases.Web of Science and PubMed were searched fo r the effects of high-frequency-repetitive transcranial magnetic stimulation,low-frequencyrepetitive transcranial magnetic stimulation,intermittent theta-bu rst stimulation,continuous thetaburst stimulation,or repetitive magnetic stimulation on non-neuronal cells in models of disease and in unlesioned animals or cells.A total of 52 studies were included.The protocol more frequently used was high-frequency-repetitive magnetic stimulation,and in models of disease,most studies report that high-frequency-repetitive magnetic stimulation led to a decrease in astrocyte and mic roglial reactivity,a decrease in the release of pro-inflammatory cyto kines,and an increase of oligodendrocyte proliferation.The trend towards decreased microglial and astrocyte reactivity as well as increased oligodendrocyte proliferation occurred with intermittent theta-burst stimulation and continuous theta-burst stimulation.Few papers analyzed the low-frequency-repetitive transcranial magnetic stimulation protocol,and the parameters evaluated were restricted to the study of astrocyte reactivity and release of pro-inflammatory cytokines,repo rting the absence of effects on these paramete rs.In what concerns the use of magnetic stimulation in unlesioned animals or cells,most articles on all four types of stimulation reported a lack of effects.It is also important to point out that the studies were developed mostly in male rodents,not evaluating possible diffe rential effects of repetitive transcranial magnetic stimulation between sexes.This systematic review supports that thro ugh modulation of glial cells repetitive magnetic stimulation contributes to the neuroprotection or repair in various neurological disease models.Howeve r,it should be noted that there are still few articles focusing on the impact of repetitive magnetic stimulation on non-neuronal cells and most studies did not perform in-depth analyses of the effects,emphasizing the need for more studies in this field.

High-frequency repetitive transcranial magnetic stimulation promotes neural stem cell proliferation after ischemic stroke

Prolife ration of neural stem cells is crucial for promoting neuronal regeneration and repairing cerebral infarction damage.Transcranial magnetic stimulation(TMS)has recently emerged as a tool for inducing endogenous neural stem cell regeneration,but its underlying mechanisms remain unclea r In this study,we found that repetitive TMS effectively promotes the proliferation of oxygen-glucose deprived neural stem cells.Additionally,repetitive TMS reduced the volume of cerebral infa rction in a rat model of ischemic stro ke caused by middle cerebral artery occlusion,im p roved rat cognitive function,and promoted the proliferation of neural stem cells in the ischemic penumbra.RNA-sequencing found that repetitive TMS activated the Wnt signaling pathway in the ischemic penumbra of rats with cerebral ischemia.Furthermore,PCR analysis revealed that repetitive TMS promoted AKT phosphorylation,leading to an increase in mRNA levels of cell cycle-related proteins such as Cdk2 and Cdk4.This effect was also associated with activation of the glycogen synthase kinase 3β/β-catenin signaling pathway,which ultimately promotes the prolife ration of neural stem cells.Subsequently,we validated the effect of repetitive TMS on AKT phosphorylation.We found that repetitive TMS promoted Ca2+influx into neural stem cells by activating the P2 calcium channel/calmodulin pathway,thereby promoting AKT phosphorylation and activating the glycogen synthase kinase 3β/β-catenin pathway.These findings indicate that repetitive TMS can promote the proliferation of endogenous neural stem cells through a Ca2+influx-dependent phosphorylated AKT/glycogen synthase kinase 3β/β-catenin signaling pathway.This study has produced pioneering res ults on the intrinsic mechanism of repetitive TMS to promote neural function recove ry after ischemic stro ke.These results provide a stro ng scientific foundation for the clinical application of repetitive TMS.Moreover,repetitive TMS treatment may not only be an efficient and potential approach to support neurogenesis for further therapeutic applications,but also provide an effective platform for the expansion of neural stem cells.

Alzheimer's disease with depressive symptoms: Clinical effect of intermittent theta burst stimulation repetitive transcranial magnetic stimulation

BACKGROUND Alzheimer's disease(AD),characterized by the ongoing deterioration of neural function,often presents alongside depressive features and greatly affects the quality of life of individuals living with the condition.Although several treatment methods exist,their efficacy is limited.In recent years,repetitive transcranial magnetic stimulation(rTMS)utilizing the theta burst stimulation(TBS)mode,specifically the intermittent TBS(iTBS),has demonstrated promising therapeutic potential in the management of neuropsychiatric disorders.AIM To examine the therapeutic efficacy of iTBS mode of rTMS for treating depressive symptoms in patients with AD.METHODS This retrospective study enrolled 105 individuals diagnosed with AD with depressive symptoms at Huzhou Third Municipal Hospital,affiliated with Huzhou University,between January 2020 and December 2023.Participants received standard pharmacological interventions and were categorized into control(n=53)and observation(n=52)groups based on treatment protocols.The observation group received iTBS mode of rTMS,while the control group received pseudo-stimulation.A comparative analysis evaluated psychological well-being,adverse events,and therapeutic at initiation of hospitalization(T0)and 15 days post-treatment(T1).RESULTS At T1,both groups exhibited a marked reduction in self-rating depression scale and Hamilton depression scale scores compared to T0.Furthermore,the observa-tion group showed a more pronounced decrease than the control group.By T1,the Mini-mental state examination scores for both groups had increased markedly from their initial T0 assessments.Importantly,the increase was particularly more substantial in the observation group than in the control group.Fourteen patients in the control group had ineffective treatment effects,while five patients in the observation group experienced the same.Additionally,the observation group experienced a substantially reduced incidence of ineffective treatment as compared to the control group(both P<0.05);there were no recorded serious adverse events in either group.CONCLUSION The iTBS model of rTMS effectively treated AD with depression,improving depressive symptoms and cognitive function in patients without serious adverse reactions,warranting clinical consideration.

Evaluation of the coefficient of lateral stress at rest of granular materials under repetitive loading conditions

Although the internal stress state of soils can be affected by repetitive loading,there are few studies evaluating the lateral stress(or K_(0))of soils under repetitive loading.This study investigates the changes in K_(0) and directional shear wave velocity(V_(s))in samples of two granular materials with different particle shapes during repetitive loading.A modified oedometer cell equipped with bender elements and a diaphragm transducer was developed to measure the variations in the lateral stress and the shear wave velocity,under repetitive loading on the loading and unloading paths.The study produced the following results:(1)Repetitive loading on the loading path resulted in an increase in the K_(0) of test samples as a function of cyclic loading number(i),and(2)Repetitive loading on the unloading path resulted in a decrease in K_(0) according to i.The shear wave velocity ratio(i.e.V_(s)(HH)/V_(s)(VH),where the first and second letters in parentheses corresponds to the directions of wave propagation and particle motion,respectively,and V and H corresponds to the vertical and horizontal directions,respectively)according to i supports the experimental observations of this study.However,when the tested material was in lightly over-consolidated state,there was an increase in K_(0) during repetitive loading,indicating that it was the initial K_(0),rather than the loading path,which is responsible for the change in K_(0).The power model can capture the variation in the K_(0) of samples according to i.Notably,the K_(0)=1 line acts as the boundary between the increase and decrease in K_(0) under repetitive loading.

Repetitive transcranial magnetic stimulation enhanced by neuronavigation in the treatment of depressive disorder and schizophrenia

This editorial assesses the advancements in neuronavigation enhanced repetitive transcranial magnetic stimulation for depressive disorder and schizophrenia treatment.Conventional repetitive transcranial magnetic stimulation faces challenges due to the intricacies of brain anatomy and patient variability.Neuronavigation offers innovative solutions by integrating neuroimaging with three-dimensional localization to pinpoint brain regions and refine therapeutic targeting.This systematic review of recent literature underscores the enhanced efficacy of neuronavigation in improving treatment outcomes for these disorders.This editorial highlights the pivotal role of neuronavigation in advancing psychiatric care.

Research on Fatigue Damage Behavior of Main Beam Sub-Structure of Composite Wind Turbine Blade

Given the difficulty in accurately evaluating the fatigue performance of large composite wind turbine blades(referred to as blades),this paper takes the main beam structure of the blade with a rectangular cross-sectionas the simulation object and establishes a composite laminate rectangular beam structure that simultaneouslyincludes the flange,web,and adhesive layer,referred to as the blade main beam sub-structure specimen,throughthe definition of blade sub-structures.This paper examines the progressive damage evolution law of the compositelaminate rectangular beam utilizing an improved 3D Hashin failure criterion,cohesive zone model,B-K failurecriterion,and computer simulation technology.Under static loading,the layup angle of the anti-shear web hasa close relationship with the static load-carrying capacity of the composite laminate rectangular beam;under fatigueloading,the fatigue damage will first occur in the lower flange adhesive area of the whole composite laminaterectangular beam and ultimately result in the fracture failure of the entire structure.These results provide a theoreticalreference and foundation for evaluating and predicting the fatigue performance of the blade main beamstructure and even the full-size blade.

Exosomes derived from microglia overexpressing miR-124-3p alleviate neuronal endoplasmic reticulum stress damage after repetitive mild traumatic brain injury

We previously reported that miR-124-3p is markedly upregulated in microglia-derived exosomes following repetitive mild traumatic brain injury.However,its impact on neuronal endoplasmic reticulum stress following repetitive mild traumatic brain injury remains unclear.In this study,we first used an HT22 scratch injury model to mimic traumatic brain injury,then co-cultured the HT22 cells with BV2 microglia expressing high levels of miR-124-3p.We found that exosomes containing high levels of miR-124-3p attenuated apoptosis and endoplasmic reticulum stress.Furthermore,luciferase reporter assay analysis confirmed that miR-124-3p bound specifically to the endoplasmic reticulum stress-related protein IRE1α,while an IRE1αfunctional salvage experiment confirmed that miR-124-3p targeted IRE1αand reduced its expression,thereby inhibiting endoplasmic reticulum stress in injured neurons.Finally,we delivered microglia-derived exosomes containing miR-124-3p intranasally to a mouse model of repetitive mild traumatic brain injury and found that endoplasmic reticulum stress and apoptosis levels in hippocampal neurons were significantly reduced.These findings suggest that,after repetitive mild traumatic brain injury,miR-124-3 can be transferred from microglia-derived exosomes to injured neurons,where it exerts a neuroprotective effect by inhibiting endoplasmic reticulum stress.Therefore,microglia-derived exosomes containing miR-124-3p may represent a novel therapeutic strategy for repetitive mild traumatic brain injury.

Analyzing the Combination Effects of Repetitive Transcranial Magnetic Stimulation and Motor Control Training on Balance Function and Gait in Patients with Stroke-Induced Hemiplegia

Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.

Study on the Effect of Repetitive Peripheral Magnetic Stimulation Combined with Conventional Rehabilitation Measures on Shoulder Dysfunction in Early Stroke

Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.

Microstructure and mechanical properties of AZ61 magnesium alloy prepared by repetitive upsetting-extrusion

The process of repetitive upsetting-extrusion （RUE） was used to achieve severe plastic deformation （SPD） for an as-cast AZ61 magnesium alloy in temperature range of 285-380 ℃. The microstructure and mechanical properties of the as-cast and RUE processed AZ61 alloys were investigated. The results indicated that homogeneous fine-grained structure with mean grain size of 3.5 μm was obtained as the accumulated true strain in the axial direction increased to 4.28 after three RUE passes at 285 ℃. The dominant reason of grain refinement was considered the dynamic recrystallization induced by strain localization. It was also found that the microstructural evolution was affected by temperature and accumulated deformation. The mechanical properties of RUE processed AZ61 alloys were significantly improved owing to grain refinement. Furthermore, the relationship between deformation parameters and mechanical properties of AZ61 alloy prepared by RUE processing was revealed by tensile tests carried out at room temperature.

The Distribution of Repetitive DNAs Along Chromosomes in Plants Revealed by Self-genomic in situ Hybridization

The distribution of repetitive DNAs along chromosomes is one of the crucial elements for understanding the organization and the evolution of plant genomes. Using a modified genomic in situ hybridization （GISH） procedure, fluorescence in situ hybridization （FISH） with genomic DNA to their own chromosomes （called self-genomic in situ hybridization, self-GISH） was carried out in six selected plant species with different genome size and amount of repetitive DNA. Nonuniform distribution of the fluorescent labeled probe DNA was observed on the chromosomes of all the species that were tested. The signal patterns varied among species and were related to the genome size. The chromosomes of the small Arabidopsis genome were labeled almost only in the pericentromeric regions and the nucleolus organizer regions （NORs）. The signals in the relatively small genomes, rice, sorghum, and Brassica oleracea var. capitata L., were dispersed along the chromosome lengths, with a predominant distribution in the pericentromeric or proximal regions and some heterochromatic arms. All chromosomes of the large genomes, maize and barley, were densely labeled with strongly labeled regions and weakly labeled or unlabeled regions being arranged alternatively throughout the lengths. In addition, enhanced signal bands were shown in all pericentromeres and the NORs in B. oleracea var. capitata, and in all pericentromeric regions and certain intercalary sites in barley. The enhanced signal band pattern in barley was found consistent with the N-banding pattern of this species. The GISH with self-genomic DNA was compared with FISH with Cot-1 DNA in rice, and their signal patterns are found to be basically consistent. Our results showed that the self-GISH signals actually reflected the hybridization of genomic repetitive DNAs to the chromosomes, thus the self-GISH technique would be useful for revealing the distribution of the regions where repetitive DNAs concentrate along chromosomes and some chromatin differentiation associated with repetitive DNAs in plants.

Microstructure and mechanical properties of AZ31-Mg_2Si in situ composite fabricated by repetitive upsetting

AZ31-4.6% Mg2Si （mass fraction） composite was prepared by conventional casting method. Repetitive upsetting （RU） was applied to severely deforming the as-cast composite at 400 ℃ for 1, 3, and 5 passes. Finite element analysis of the material flow indicates that deformation concentrates in the bottom region of the sample after 1 pass, and much more uniform deformation is obtained after 5 passes. During multi-pass RU process, both dendritic and Chinese script type Mg2Si phases are broken up into smaller particles owing to the shear stress forced by the matrix. With the increasing number of RU passes, finer grain size and more homogeneous distribution of Mg2Si particles are obtained along with significant enhancement in both strength and ductility. AZ31-4.6%Mg2Si composite exhibits tensile strength of 284 MPa and elongation of 9.8%after 5 RU passes at 400 ℃ compared with the initial 128 MPa and 5.4%of original AZ31-4.6%Mg2Si composite.

Repetitive代数的导出等价

若代数A和B导出等价,则它们的Repetitive代数■和■也是导出等价,从而是稳定等价.这样利用更直接的代数方法完全回答了H.Asashiba提出的问题,并推广了Rickard,杜先能,Tachikawa-Wakamatsu等人的相应结果.进而,把以上结果推广到上有界复形的导出范畴的对称recollement的情形.

Design and analysis of dual-mode structure repetitive control based hybrid current regulation scheme for active power filters

An all-digital hybrid current regulation scheme for the single-phase shunt active power filter （APF） is presented. The proposed hybrid current control scheme integrates the deadbeat control and the dual-mode structure repetitive control （DMRC） so that it can offer superior steady-state performance and good transient features. Unlike the conventional schemes, the proposed scheme-based APF can compensate both the odd and the even order harmonics in grid. The detailed design criteria and the stability analysis of the proposed hybrid current controller are presented. Moreover, an improved structure which incorporates the proposed hybrid controller and the resonant controller for tracking specific order harmonics is given. The relationships between the resonant controller and different repetitive control schemes are discussed. Experimental results verify the effectiveness and advantages of the proposed hybrid control scheme.

Effect of Acupuncture Cooperated with Low-frequency Repetitive Transcranial Magnetic Stimulation on Chronic Insomnia： A Randomized Clinical Trial

The effect of acupuncture cooperated with low-frequency repetitive transcranial magnetic stimulation （rTMS） on chronic insomnia was explored. Seventy-eight patients with chronic insomnia were randomly allocated into two groups： treatment group and control group. In the treatment group, the patients received acupuncture combined with rTMS treatment, and those in the control group were given acupuncture cooperated with sham rTMS treatment, 3 days per week for 4 weeks. Before and after treatment, the primary outcomes including the scores on Insomnia Severity Index （ISI） and Pittsburgh Sleep Quality Index （PSQI） and the secondary outcomes including total sleep time （TST）, sleep onset latency （SOL）, wake after sleep onset （WASO）, sleep efficiency （SE%） recorded by sleeping diary and actigraphy were observed in both groups. Seventy-five participants finished the study （38 in treatment group and 37 in control group respectively）. After treatment, the scores in the two groups were improved significantly, more significantly in the treatment group than in the control group. It can be inferred that acupuncture cooperated with rTMS can effectively improve sleep quality, enhance the quality of life of patients and has less side effects.

Clinical application of repetitive transcranial magnetic stimulation in stroke rehabilitation

Proper stimulation to affected cerebral hemisphere would promote the functional recovery of patients with stroke. Effects of repetitive transcranial magnetic stimulation on cortical excitability can be can be altered by the stimulation frequency, intensity and duration. There has been no consistent recognition regarding the best stimulation frequency and intensity. This study reviews the intervention effects of repetitive transcranial stimulation on motor impairment, dysphagia, visuospatial neglect and aphasia, and summarizes the stimulation frequency, intensity and area for repetitive transcranial magnetic stimulation to yield the best therapeutic effects.

Repetitive magnetic stimulation affects the microenvironment of nerve regeneration and evoked potentials after spinal cord injury

Repetitive magnetic stimulation has been shown to alter local blood flow of the brain, excite the corticospinal tract and muscle, and induce motor function recovery. We established a rat model of acute spinal cord injury using the modified Allen＇s method. After 4 hours of injury, rat models received repetitive magnetic stimulation, with a stimulus intensity of 35% maximum output intensity, 5-Hz frequency, 5 seconds for each sequence, and an interval of 2 minutes. This was repeated for a total of 10 sequences, once a day, 5 days in a week, for 2 consecutive weeks. After repetitive magnetic stimulation, the number of apoptotic cells decreased, matrix metalloproteinase 9/2 gene and protein expression decreased, nestin expression increased, somatosensory and motor-evoked potentials recovered, and motor function recovered in the injured spinal cord. These findings confirm that repetitive magnetic stimulation of the spinal cord improved the microenvironment of neural regeneration, reduced neuronal apoptosis, and induced neuroprotective and repair effects on the injured spinal cord.

Low frequency repetitive transcranial magnetic stimulation improves motor dysfunction after cerebral infarction

Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of cerebral infarction, whether it promotes the recovery of motor function remains controversial. Twenty patients with cerebral infarction combined with hemiparalysis were equally and randomly divided into a low frequency rTMS group and a control group. The patients in the low frequency rTMS group were given 1-Hz rTMS to the contralateral primary motor cortex with a stimulus intensity of 90% motor threshold, 30 minutes/day. The patients in the control group were given sham stimulation. After 14 days of treatment, clinical function scores （National Institute of Health Stroke Scale, Barthel Index, and Fugl-Meyer Assessment） improved significantly in the low frequency rTMS group, and the effects were better than that in the control group. We conclude that low frequency （1 Hz） rTMS for 14 days can help improve motor function after cerebral infarction.

Effects of High Frequency Repetitive Transcranial Magnetic Stimulation on KCC2 Expression in Rats with Spasticity Following Spinal Cord Injury

The effect of high-frequency repetitive transcranial magnetic stimulation（r TMS） on potassium-chloride cotransporter-2（KCC2） protein expression following spinal cord injury（SCI） and the action mechanism were investigated. SCI models were established in SD rats. Five groups were set up randomly： normal control group, SCI 7-day（7 D） model group, SCI 14-day（14 D） model group, SCI-7 DrTMS group and SCI-14 DrTMS group（n=5 each）. The rats in SCI rTMS groups were treated with 10 Hz rTMS from 8 th day and 15 th day after SCI respectively, once every day, 5 days every week, a total of 4 weeks. After the model establishment, motor recovery and spasticity alleviation were evaluated with BBB scale once a week till the end of treatment. Finally, different parts of tissues were dissected out for detection of variations of KCC2 protein using Western blotting and polymerase chain reaction（PCR） technique. The results showed that the BBS scores after treatment were significantly higher in SCI-7 DrTMS group than in SCI-14 DrTMS group（P〈0.05）. As compared with normal control groups, The KCC2 protein in SCI model groups was down-regulated after SCI, and the decrease was much more significant in SCI-14 D model group than in SCI-7 D group（P〈0.05）. As compared with SCI model groups, KCC2 protein in rTMS groups was up-regulated after the treatment（P〈0.05）. The up-regulation of KCC2 protein content and expression was more obvious in SCI-7 DrTMS group than in SCI-14 DrTMS group（P〈0.05）. It was concluded that 10 Hz rTMS can alleviate spasticity in rats with SCI, which might be attributed to the up-regulation of KCC2 protein. It was also suggested that the high-frequency rTMS treatment after SCI at early stage might achieve more satisfactory curative effectiveness.