Objective  To explore the efficacy of repeated transcranial magnetic stimulation (rTMS) combined with flupentixol and melitracen tablets on post-stroke depression (PSD) and to evaluate the predictive value of depressive symptom dimensions on the efficacy.

Methods  PSD patients diagnosed and treated in the department of rehabilitation medicine of Jiaozhou Central Hospital of Qingdao from January 2021 to December 2023 were selected as the research subjects, all patients were treated with rTMS combined with flupentixol and melitracen tablets. The National Institutes of Health Stroke Scale (NIHSS), Hamilton Depression (HAMD), and Barthel Index (BI) of PSD patients before and after treatment were evaluated and compared. PSD patients were divided into the effective group and the ineffective group based on treatment effectiveness, and Logistic regression was used to explore the relationship between depression symptom dimensions and treatment outcomes. Using the receiver operating characteristic  (ROC) curve to explore the predictive value of depression symptom dimensions on the efficacy of PSD patients.

Results  A total of 80 PSD patients were included in this study, of which 68 cases were effective in treatment and 12 cases were ineffective in treatment. Compared with before treatment, PSD patients showed a significant decrease in HAMD score, NIHSS score (P<0.05), and BI score was significant increased (P<0.05). The observed mood (OM) score, cognitive score, and neurological symptom (NS) score of PSD patients in the effective group were higher than those in the ineffective group, and the differences were statistically significant (P<0.05). Logistic regression analysis showed that high-level OM score, cognitive score, and NS score were independent protective factors for effective PSD treatment. ROC analysis showed that the baseline OM score, cognitive score, and NS score for ineffective treatment were 0.744[95%CI (0.568, 0.921)], 0.734 [95%CI (0.572, 0.896)], and 0.709[95%CI 0.534, 0.884)], respectively.

Conclusion  rTMS combined with flupentixol and melitracen tablets can significantly improve depression symptoms and neurological impairment, and improve the ability of daily living. Moreover, depressive symptom dimensions at baseline can predict the treatment effects of PSD patients.

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