Objective  To investigate the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on neuroelectrophysiology and cerebrospinal fluid excitatory amino acid (EAA) level in patients with disorders of consciousness (DOC) after severe craniocerebral injury.

  Methods  Eighty patients with DOC after severe craniocerebral injury in Yanjiao People′s Hospital of Sanhe City from October 2018 to December 2019 were selected and randomly divided into control group and treatment group, with 40 cases in each group. The rTMS sham stimulation was performed 4 weeks in the control group, while rTMS stimulation was performed 4 weeks in the treatment group. The Glasgow Coma Scale (GCS) score, modified Coma Recovery Scale (CRS-R) score, electroencephalogram (EEG) grading, upper limb somatosensory evoked potential (SSEP) grading, glutamate (ASP) and glutamate (GLU) levels were compared between the two groups before and after treatment.

  Results  The GCS and CRS-R scores in both groups after treatment were significantly higher than those before treatment, and the GCS and CRS-R scores in the treatment group after treatment were significantly higher than those in the control group (P < 0.05). The change of EEG after treatment in the treatment group was more obvious than that before treatment and in the control group, and there were significant differences (P < 0.05). After treatment, SSEP in both groups were changed, the change of SSEP in the treatment group was more obvious than that in the control group, and there was a significant difference (P < 0.05). After treatment, GLU and ASP in both groups were significantly lower than those before treatment, and GLU and ASP after treatment in the treatment group were significantly lower than those in the control group (P < 0.05).

  Conclusion  Application of high-frequency rTMS in DOC patients after severe craniocerebral injury can improve neurophysiological activity and coma status, and reduce cerebrospinal fluid EAA level.