INFLUENCE OF TRANSCRANIAL MAGNETIC STIMULATION ON THE ACTIVATION OF NEUROPLASTICITY PROCESSES AND NEUROTROPHIC FACTORS IN THE ACUTE PERIOD OF STROKE

The acute period of ischemic stroke is characterized by the formation of an ischemic penumbra zone, where neurons retain structural integrity but temporarily lose functional activity. Functional recovery in this zone directly depends on the speed of initiating neuroplasticity mechanisms — the brain's ability to reorganize neural connections. A key role in this process is played by neurotrophic factors, particularly brain-derived neurotrophic factor (BDNF), which supports neuronal survival and stimulates synaptogenesis. Repetitive transcranial magnetic stimulation (rTMS) is a powerful tool for non-invasive neuromodulation; however, its effect on BDNF levels and markers of neuroplasticity specifically in the acute phase of stroke has been insufficiently studied 11.缺血性脑卒中（ischemic stroke）的急性期以缺血半暗带（ischemic penumbra zone）的形成为特征，该区域内的神经元虽保留结构完整性，却暂时丧失功能活性。此区域的功能恢复直接取决于神经可塑性（neuroplasticity）机制启动的速度——即大脑重塑神经连接的能力。神经营养因子（neurotrophic factors）在该过程中发挥关键作用，尤以脑源性神经营养因子（brain-derived neurotrophic factor, BDNF）为甚，其可支持神经元存活并促进突触发生（synaptogenesis）。重复经颅磁刺激（repetitive transcranial magnetic stimulation, rTMS）是一种强有力的非侵入性神经调控工具；然而，其对BDNF水平以及脑卒中急性期特异性神经可塑性标志物的影响尚缺乏充分研究11。