Background
Repetitive transcranial magnetic stimulation (rTMS) has become a popular approach for the treatment of traumatic brain injury (TBI). This study aimed to assess the efficacy and underlying mechanism of rTMS in TBI model rats.
Methods
Forty-five rats were randomized into SHAM, TBI, and rTMS (TBI and rTMS therapy) groups. Moderate TBI was established using Feeney's weight-dropping method. High-frequency rTMS (20 Hz) was administered to the damaged area in the rTMS group for two weeks. Neural function was assessed by modified neurological severity score (MNSS) at 3, 9, and 16 days after TBI. Synaptic ultrastructure was observed by transmission electron microscopy and levels of synaptic plasticity-related proteins (BDNF, TrkB, NMDAR1, P-CREB, and SYN) were assessed by immunohistochemistry, Western blotting, and real-time PCR.
Results
The rTMS group showed a lower MNSS than the TBI group at 16 days (P < 0.05). Compared to the TBI group, the postsynaptic density (PSD) was increased, the width of the synaptic cleft was decreased, and the synaptic active zone was lengthened in the rTMS group (all P < 0.05). Compared with the sham group, protein levels and mRNA expression of BDNF, TrkB, NMDAR1, and P-CREB were increased in the TBI group (P < 0.05) and further upregulated after rTMS treatment (P < 0.05). In addition, rTMS partially reversed downregulation of SYN (P < 0.05).
Conclusions
Taken together, these findings support that rTMS improves neural functional recovery in TBI rats. The possible mechanism is that rTMS modulates synaptic structural plasticity by reducing loss of SYN and alters synaptic functional plasticity by increasing cortical levels of BDNF, TrkB, NMDAR1, and P-CREB.