71. Repetitive Transcranial Magnetic Stimulation (rTMS) applied with H-coil in Alzheimer’s disease: A placebo-controlled, double-blind, pilot study

Past, Present, and Future of Non-invasive Brain Stimulation Approaches to Treat Cognitive Impairment in Neurodegenerative Diseases: Time for a Comprehensive Critical Review

“…During left parietal cortex stimulation, patients displayed a reduction of vocal reaction times for the naming of actions (in which they were mostly impacted) but not for objects. Interestingly, the authors also reported recovery size-effects that scaled with the level of baseline (pre-treatment) impairment, suggesting, as reported previously for interventions in sv-PPA ( McConathey et al, 2017 ) but at difference with AD ( Ahmed et al, 2012 ; Coppi et al, 2016 ), that the most clinically severe cases are the most likely to improve their sympthoms with tDCS.…”

“…Severity dependent outcomes were also observed in another study in which only patients with mild but not moderate AD responded to rTMS stimulation and displayed significant improvements in different cognitive scales ( Zhao et al, 2017 ). In the same vein, two other studies also showed greater improvement in the ADAS-cog subscale ( Coppi et al, 2016 ), the MMSE and a word-image association task ( Rutherford et al, 2015 ) after a high frequency rTMS treatment in patients with less severe cognitive impairment at baseline. Finally, the study from Sabbagh et al (2019) , involving a large cohort of patients ( n = 129), showed stronger improvements in mild AD patients (ADAS-Cog < 30) compared to more severely affected patients (Adas-Cog > 30).…”

“…Another study correlated response outcomes with baseline performance prior to a regime of cumulative tDCS sessions and showed severity-dependent response to tDCS in sv-PPA. Nonetheless in contrast with outcomes in AD ( Ahmed et al, 2012 ; Coppi et al, 2016 ), in this case, poor baseline performance was associated to better outcomes ( McConathey et al, 2017 ).…”

“…Small cohort studies addressing the effects of TMS/tDCS on cognitive deficits in AD have shown promising benefits. High frequency rTMS over the right ( Cotelli et al, 2006 , 2008 ; Ahmed et al, 2012 ; Rutherford et al, 2015 ) and left dorsolateral prefrontal cortex (DLPFC; Cotelli et al, 2006 , 2008 , 2011 ; Ahmed et al, 2012 ; Rutherford et al, 2015 ; Wu et al, 2015 ) combined ( Cotelli et al, 2006 , 2008 ; Rutherford et al, 2015 ) or not ( Cotelli et al, 2011 ; Ahmed et al, 2012 ; Wu et al, 2015 ) with online (during stimulation) cognitive tasks have showed beneficial effects in picture naming, auditory sentence comprehension and in the scores of the Mini-Mental State Examination (MMSE; Folstein et al, 1975 ), the Instrumental Activities of Daily Living (IADL; Lawton and Brody, 1988 ), the Geriatric Depression Scale (GDS; Yesavage et al, 1983 ), and the cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-cog scale; Rosen et al, 1984 ; Coppi et al, 2016 ). Moreover, improvements observed for the MMSE, GDS, and IADL scores ( Ahmed et al, 2012 ) and for auditory comprehension ( Cotelli et al, 2011 ) lasted for at least 2 months.…”

Modulating microcircuits in depression

“…For this reason different 'H' coils are designed for different disorders. For Alzheimer disease, findings suggest some improvements in the Alzheimer's disease assessment scale-cognitive subscale when treated with dTMS (Coppi 2016). A possible refinement of this technique could be the combination of dTMS with MNPs to enhance or transduce the signal.…”