Cortical plasticity is correlated with cognitive improvement in Alzheimer’s disease patients after rTMS treatment

Li, Xingxing; Qi, Gangqiao; Yu, Chang; Lian, Guomin; Hong, Zheng; Wu, Shaochang; Yuan, Ti‐Fei; Zhou, Dongsheng

doi:10.1016/j.brs.2021.01.012

Cited by 89 publications

(101 citation statements)

References 53 publications

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“…This implies that the cognitive improvements in patients under rTMS treatment were not due to alleviation of depressive symptoms. Notably, the findings of the current study showed that rTMSinduced cognitive improvement was reduced at 12-week follow-up in subjects in the treatment group which is consistent with findings from a previous study [50] which reported that 30 sessions comprising 20Hz rTMS treatment over a six-week period in the DLPFC significantly improved cognitive function of patients, although this improvement could not be maintained during a three-month follow up period. This can be attributed to rTMS dosage, and its combination with other therapeutic approaches.…”

Section: Parietal-hippocampal Targeted Rtms Improves Cognitive Function In Alzheimer's Disease Patientssupporting

confidence: 91%

Parietal-Hippocampal rTMS Improves Cognitive Function in Alzheimer's Disease by Inducing Increased Dynamic Functional Connectivity of Default Mode Network

Wei¹,

Zhang²,

Wang³

et al. 2021

Preprint

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Background Alzheimer’s disease, a neurodegenerative disease with significant social and economic impact, is mainly treated by focusing on decelerating cognition decline. Parietal-hippocampal repetitive transcranial magnetic stimulation (rTMS) improves memory and cognitive function in Alzheimer’s disease, however, the underlying therapeutic mechanism has not been elucidated. Methods A double-blind, randomized, sham-controlled parietal-hippocampal rTMS trial of mild-to-moderate Alzheimer's disease patients was conducted in the current study. High-frequency rTMS was applied to a subject-specific left lateral parietal region with the highest functional connectivity with the hippocampus based on resting-state fMRI. Patients were randomized to either rTMS or sham treatment (five sessions/week for a total of 10 sessions). A multimodal MRI scan and a complete neuropsychological battery of tests were conducted at baseline, immediately after the intervention and 12-week follow-up after the rTMS treatment. Primary outcomes were differences in the Mini Mental State Examination (MMSE) and Philadelphia Verbal Learning Test (PVLT) scores between the groups and between pre- and post-treatment. Moreover, flexible least squares (FLS) method was used to calculate the dynamic functional connectivity (dFC) of the default mode network (DMN), and dFC changes were compared between the groups and between pre- and post-treatment. Results Patients undergoing active rTMS treatment (n = 31) for two weeks showed higher MMSE, PVLT-Immediate recall, and PVLT-Short Delay recall scores, whereas those who underwent sham rTMS (n = 27) treatment did not show significant changes in these measures. Dynamic functional connectivity (dFC) magnitude of the default mode network (DMN) was significantly higher after two weeks of rTMS treatment in the patients who underwent active-rTMS treatment, however, no significant changes were observed in patients who received sham-rTMS treatment. dFC magnitude reduced to baseline level at 12-week follow-up, which resembled the trajectory of the cognitive measures. A significant positive correlation was observed between changes in MMSE and changes in the dFC magnitude of DMN in patients who underwent active-rTMS treatment, but not in those who received sham-rTMS treatment. Conclusions The findings of the current study indicate that fMRI-guided rTMS treatment improves memory and cognitive function of Alzheimer's disease patients. In addition, the findings indicate that the DMN functional connectivity contributes to therapeutic effectiveness of rTMS. Trial registration: China National Medical Research Platform (http://114.255.48.20/login, No:MR-33-20-004217), retrospectively registered 2020-12-23.

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Section: Parietal-hippocampal Targeted Rtms Improves Cognitive Function In Alzheimer's Disease Patientssupporting

confidence: 91%

Parietal-Hippocampal rTMS Improves Cognitive Function in Alzheimer's Disease by Inducing Increased Dynamic Functional Connectivity of Default Mode Network

Wei¹,

Zhang²,

Wang³

et al. 2021

Preprint

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“…Our results showed that the rTMS-induced cognitive improvement in the active-rTMS group disappeared at 12-week follow-up. It was similar to a recent study [49], which reported that 20Hz rTMS treatment for 30 sessions over six weeks in the DLPFC resulted in a significant improvement in cognition, but this improvement was not maintained in the three-month follow up. rTMS dose and its combination with other therapeutic approaches were important issues in this case.…”

Section: Parietal-hippocampal Targeted Rtms Can Improve Cognitive Function In Alzheimer's Diseasesupporting

confidence: 91%

Cognitive Improvement is Correlated with Increased Dynamic Functional Connectivity of Default Mode Network by Personalized rTMS in Alzheimer's Disease

Wei¹,

Wang²,

Zhang³

et al. 2021

Preprint

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Background Repetitive transcranial magnetic stimulation (rTMS) is thought to be a promising therapeutic approach for Alzheimer's disease patients. Methods In the present report, a double-blind, randomized, sham-controlled rTMS trial was conducted in mild-to-moderate Alzheimer's disease patients. High-frequency rTMS was delivered to a subject-specific left lateral parietal region that demonstrated highest functional connectivity with the hippocampus using resting-state fMRI. The Mini Mental State Examination (MMSE) and Philadelphia Verbal Learning Test (PVLT) were used to evaluate patients’ cognitive functions. Results Patients receiving active rTMS treatment (n = 31) showed a significant increase in the MMSE, PVLT-Immediate recall, and PVLT-Short Delay recall scores after two weeks of rTMS treatment, whereas patients who received sham rTMS (n = 27) did not show significant changes in these measures. Dynamic functional connectivity (dFC) magnitude of the default mode network (DMN) in the active-rTMS group showed a significant increase after two weeks of rTMS treatment, and no significant changes were found in the sham-rTMS group. There was a significantly positive correlation between changes of the MMSE and changes of the dFC magnitude of DMN in the active-rTMS group, but not the sham-rTMS group. Conclusions Our findings are novel in demonstrating the feasibility and effectiveness of the fMRI-guided rTMS treatment in Alzheimer's disease patients, and DMN might play a vital role in therapeutic effectiveness of rTMS in Alzheimer’s disease. Trial registration: China National Medical Research Platform (http://114.255.48.20/login, No:MR-33-20-004217), retrospectively registered 2020-12-23.

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“…rTMS of left dlPFC has produced moderately consistent effects on RSFC but less consistent cognitive outcomes. Regarding cognitive changes associated with left dlPFC rTMS, eight of twelve studies reviewed here reported significant cognitive improvements associated with high-frequency stimulation [14,33,34,37,38,40,41,[43][44][45]70,71]. Further, one study using low-frequency rTMS reported acute cognitive impairment [42].…”

Section: Review Of Prior Work 21 Organization Of the Reviewmentioning

confidence: 72%

“…Fortunately, recent findings suggest that targeted non-invasive brain stimulation (NBS) may offer meaningful opportunities for treatment [10]. Specifically, transcranial magnetic stimulation (TMS), a form of NBS, has been reported to improve memory in healthy younger adults, healthy older adults, and individuals with AD [11][12][13][14]. TMS may therefore hold promise as a potential symptomatic treatment for memory loss.…”

Section: Introductionmentioning

confidence: 99%

Stimulating Memory: Reviewing Interventions Using Repetitive Transcranial Magnetic Stimulation to Enhance or Restore Memory Abilities

2021

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Human memory systems are imperfect recording devices that are affected by age and disease, but recent findings suggest that the performance of these systems may be modifiable through interventions using non-invasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS). The translational potential of these rTMS interventions is clear: memory problems are the most common cognitive complaint associated with healthy aging, while pathological conditions such as Alzheimer’s disease are often associated with severe deficits in memory. Therapies to improve memory or treat memory loss could enhance independence while reducing costs for public health systems. Despite this promise, several important factors limit the generalizability and translational potential of rTMS interventions for memory. Heterogeneity of protocol design, rTMS parameters, and outcome measures present significant challenges to interpretation and reproducibility. However, recent advances in cognitive neuroscience, including rTMS approaches in addition to a new understanding of functional brain networks and related insights, may offer methodological tools necessary to design new interventional studies with enhanced experimental rigor, improved reproducibility, and greater likelihood of successful translation to clinical settings. In this review, we first discuss the current state of the literature on memory modulation with rTMS, then offer a commentary on developments in cognitive neuroscience that are relevant to rTMS interventions, and finally close by offering several recommendations for the design of future investigations using rTMS to modulate human memory performance.

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Cortical plasticity is correlated with cognitive improvement in Alzheimer’s disease patients after rTMS treatment

Cited by 89 publications

References 53 publications

Parietal-Hippocampal rTMS Improves Cognitive Function in Alzheimer's Disease by Inducing Increased Dynamic Functional Connectivity of Default Mode Network

Parietal-Hippocampal rTMS Improves Cognitive Function in Alzheimer's Disease by Inducing Increased Dynamic Functional Connectivity of Default Mode Network

Cognitive Improvement is Correlated with Increased Dynamic Functional Connectivity of Default Mode Network by Personalized rTMS in Alzheimer's Disease

Stimulating Memory: Reviewing Interventions Using Repetitive Transcranial Magnetic Stimulation to Enhance or Restore Memory Abilities

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