30 - 50% of stroke survivors develop depression during the first six months known as post-stroke depression (PSD). Repetitive transcranial magnetic stimulation (rTMS) is an FDA-approved therapy for the treatment of major depression in psychiatric cases. However, rTMS is being investigated for the treatment of post-stroke depression (PSD). Preliminary reports suggest that excitatory 10 Hz rTMS applied over left Dorsolateral Prefrontal cortex (L-DLPFC) area has a beneficial effect in reducing PSD symptoms. However, systematic meta-analyses of those studies suggest that they suffer from several drawbacks. Reducing PSD is important because it can enhance the post-stroke motor recovery. It can enhance motor recovery either due to motivational benefits or directly by strengthening the cortical connections, but this has not been tested in detail yet. Thus, in this work it is hypothesised that excitatory 10 Hz rTMS of L-DLPFC will reduce PSD symptoms and reduction of depression will enhance motor recovery either due to motivational or other benefits. To assess that in this work MCA ischemic stroke patients suffering from PSD and hemiplegia were recruited and provided the excitatory rTMS treatment. Our results suggest that the given rTMS treatment is effective in reducing PSD symptoms significantly but has no immediate impact on motor function in those patients. In future studies, it is planned to study the long-term impact of PSD reduction on motor-recovery.

Keywords:Post-stroke depression; rTMS; Middle Cerebral Artery (MCA) Occlusion; Ischemic stroke; Motor recovery