EFEITOS COGNITIVOS DA ESTIMULAÇÃO MAGNÉTICA TRANSCRANIANA SOBRE O CÓRTEX MOTOR PRIMÁRIO DE PACIENTES PÓS ACIDENTE VASCULAR CEREBRAL: Revisão sistemática e metanálise

Introduction: This study aimed to carry out a systematic review of the effect of repetitive transcranial magnetic stimulation (rTMS) on cognition in post-stroke patients stimulated in the primary motor cortex (M1), this stimulus is widely used for motor recovery, but is poor investigated for cognitive outcomes. Method: Two independent reviewers selected and assessed the quality of the studies; ten studies were selected for reading, but only three articles and one thesis met the inclusion criteria. Results: The four studies aimed to verify motor improvement after stroke and assessed the repercussions on cognition through tests, including the Mini-Mental State Examination. Two of them found a relationship between motor improvement and positive repercussions on cognition, suggesting inhibition in M1 as a way of re-establishing hemispheric balance or influencing the connection of other distant areas of the brain, and the other two found no significant effect on cognition, but also no negative interference. Conclusion: There is evidence that M1 stimulation positively alters cognition in patients after stroke. This result strengthens the systemic view of brain interconnections and of the primary motor cortex being an access point for stimulating and impacting functions of a complex nature.