Parietal-hippocampal rTMS improves cognitive function in Alzheimer's disease and increases dynamic functional connectivity of default mode network

Wei, Lili; Zhang, Yingchun; Wang, Jintao; Xu, Liang; Yang, Kehua; Lv, Xinghui; Zhu, Ziling; Gong, Qian; Hu, Weiming; Li, Xia; Qian, Mincai; Shen, Yongjia; Chen, Wei

doi:10.1016/j.psychres.2022.114721

Cited by 32 publications

(15 citation statements)

References 60 publications

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“…Four RCTs reported the changes of FC in patients with AD after NIBS. Wei et al 39 reported a significantly higher dFC magnitude of DMN in patients in the treatment group, compared with the sham group, after rTMS intervention. Moreover, rTMS significantly increased intranetwork connectivity of FPN 41 and enhanced local and global functional integration within bilateral angular gyrus 42 .…”

Section: Resultsmentioning

confidence: 99%

“…By searching the four databases mentioned above, a total of 1,472 articles were found. Finally, 17 studies 28-4 4 comprising 258 patients in the treatment group and 256 patients in the control group were identified in the review based on the inclusion and exclusion criteria, including 6 tDCS [28][29][30][31][32][33] and 11 rTMS [34][35][36][37][38][39][40][41][42][43][44] Similarly, the treatment time lasted from 4 weeks to 3 months. Four trails reported adverse effects that were slightly transient and well tolerated.…”

Section: Included Studies and Sample Characteristicsmentioning

confidence: 99%

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The effects of noninvasive brain stimulation on cognitive function in patients with mild cognitive impairment and Alzheimer's disease using resting‐state functional magnetic resonance imaging: A systematic review and meta‐analysis

Wang

Yan

2023

CNS Neurosci Ther

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ObjectiveThe aim of this systematic review and meta‐analysis was to evaluate the efficacy of noninvasive brain stimulation (NIBS) on cognition using functional magnetic resonance imaging (fMRI) in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), thus providing the neuroimaging mechanism of cognitive intervention.MethodsEnglish articles published up to April 30, 2023 were searched in the PubMed, Web of Science, Embase, and Cochrane Library databases. We included randomized controlled trials where resting‐state fMRI was used to observe the effect of NIBS in patients with MCI or AD. RevMan software was used to analyze the continuous variables, and SDM‐PSI software was used to perform an fMRI data analysis.ResultsA total of 17 studies comprising 258 patients in the treatment group and 256 in the control group were included. After NIBS, MCI patients in the treatment group showed hyperactivation in the right precuneus and decreased activity in the left cuneus and right supplementary motor area. In contrast, patients in the control group showed decreased activity in the right middle frontal gyrus and no hyperactivation. The clinical cognitive scores in MCI patients were significantly improved by NIBS, while not in AD. Some evidence regarding the modulation of NIBS in resting‐state brain activity and functional brain networks in patients with AD was found.ConclusionsNIBS could improve cognitive function in patients with MCI and AD. fMRI evaluations could be added to evaluate the contribution of specific NIBS treatment therapeutic effectiveness.

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Section: Resultsmentioning

confidence: 99%

Section: Included Studies and Sample Characteristicsmentioning

confidence: 99%

The effects of noninvasive brain stimulation on cognitive function in patients with mild cognitive impairment and Alzheimer's disease using resting‐state functional magnetic resonance imaging: A systematic review and meta‐analysis

Wang

Yan

2023

CNS Neurosci Ther

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“…Among the various stimulation sites explored, the dorsolateral prefrontal cortex (DLPFC) emerged as a frequently targeted region across multiple studies [ 25, 43, 51–57 ]. Additionally, other targets included the hippocampus [ 36, 58 ], angular gyrus [ 59 ], precuneus [ 60 ], cerebellum [ 61 ], and regions adjacent to the temporal lobe [ 34, 62 ]. While the majority of studies utilized one or two stimulation sites with treatment frequency of 10 Hz and 20 Hz, two studies utilized low-frequency stimulation at 1 Hz [ 43 ] and 5 Hz [ 61 ].…”

Section: Resultsmentioning

confidence: 99%

Unlocking the Potential of Repetitive Transcranial Magnetic Stimulation in Alzheimer’s Disease: A Meta-Analysis of Randomized Clinical Trials to Optimize Intervention Strategies

Li,

Lan,

Liu

et al. 2024

JAD

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Background: Repetitive transcranial magnetic stimulation (rTMS) is an advanced and noninvasive technology that uses pulse stimulation to treat cognitive impairment. However, its specific effects have always been mixed with those of cognitive training, and the optimal parameter for Alzheimer’s disease (AD) intervention is still ambiguous. Objective: This study aimed to summarize the therapeutic effects of pure rTMS on AD, excluding the influence of cognitive training, and to develop a preliminary rTMS treatment plan. Methods: Between 1 January 2010 and 28 February 2023, we screened randomized controlled clinical trials from five databases (PubMed, Web of Science, Embase, Cochrane, and ClinicalTrials. gov). We conducted a meta-analysis and systematic review of treatment outcomes and rTMS treatment parameters. Result: A total of 4,606 articles were retrieved. After applying the inclusion and exclusion criteria, 16 articles, comprising 655 participants (308 males and 337 females), were included in the final analysis. The findings revealed that rTMS significantly enhances both global cognitive ability (p = 0.0002, SMD = 0.43, 95% CI = 0.20–0.66) and memory (p = 0.009, SMD = 0.37, 95% CI = 0.09–0.65). Based on follow-up periods of at least 6 weeks, the following stimulation protocols have demonstrated efficacy for AD: stimulation sites (single or multiple targets), frequency (20 Hz), stimulation time (1–2 s), interval (20–30 s), single pulses (≤2500), total pulses (>20000), duration (≥3 weeks), and sessions (≥20). Conclusions: This study suggests that rTMS may be an effective treatment option for patients with AD, and its potential therapeutic capabilities should be further developed in the future.

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“…41 Moreover, HF-rTMS delivered bilaterally to the PC elevates the corresponding neuronal activity to activate the DMN, which contributes to the improvement of patients' cognitive performance. 51,91 Additionally, 5 Hz-rTMS delivered bilaterally to the cerebellum effectively activates the cerebellar-cortical network, thereby improving global cognition in patients with AD. 40 These data suggest that rTMS could directly stimulate the local neurons in key brain regions, and consequently, activate the corresponding brain networks, which is consistent with the evidence that a similar effect of cognitive improvement is observed when delivering single-site and multisite rTMS to patients with AD.…”

Section: How Rtms Modulates Neural Network In Brains Of Patients With Admentioning

confidence: 99%

Neuroprotective effects of repetitive transcranial magnetic stimulation on Alzheimer's disease: Undetermined therapeutic protocols and mechanisms

Zhu,

Liao,

Gao

et al. 2024

Neuroprotection

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Alzheimer's disease (AD) is a prevalent neurodegenerative disorder characterized by gradual deterioration of cognitive functions, for which an effective treatment is currently unavailable. Repetitive transcranial magnetic stimulation (rTMS), a well‐established noninvasive brain stimulation method, is utilized in clinical settings to address various neuropsychiatric conditions, such as depression, neuropathic pain, and poststroke dysfunction. Increasing evidence suggests that rTMS may enhance cognitive abilities in individuals with AD. However, its optimal therapeutic protocols and precise mechanisms are currently unknown, impeding its clinical implementation. In the present review, we aimed to summarize and discuss the efficacy‐related parameters in rTMS treatment, encompassing stimulus frequency, stimulus pattern, stimulus intensity, and the configuration of the stimulus coil. Furthermore, we reviewed promising rTMS therapeutic protocols involving various combinations of these factors, that were examined in clinical studies. Based on our analysis, we propose that a multisite high‐frequency rTMS (HF‐rTMS) regimen has value in AD therapy, and that promising single‐site protocols, such as HF‐rTMS, applied over the left dorsolateral prefrontal cortex, precuneus, or cerebellum are required to be validated in larger clinical studies. Lastly, we provide a comprehensive review of the potential mechanisms underlying the neuroprotective effects of rTMS on cognition in AD in terms of brain network modulation as well as cellular and molecular reactions. In conclusion, the interaction of diverse mechanisms may be responsible for the total therapeutic effect of rTMS on AD. This review provides theoretical and practical evidence for the future clinical application and scientific research of rTMS in AD.

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Parietal-hippocampal rTMS improves cognitive function in Alzheimer's disease and increases dynamic functional connectivity of default mode network

Cited by 32 publications

References 60 publications

The effects of noninvasive brain stimulation on cognitive function in patients with mild cognitive impairment and Alzheimer's disease using resting‐state functional magnetic resonance imaging: A systematic review and meta‐analysis

The effects of noninvasive brain stimulation on cognitive function in patients with mild cognitive impairment and Alzheimer's disease using resting‐state functional magnetic resonance imaging: A systematic review and meta‐analysis

Unlocking the Potential of Repetitive Transcranial Magnetic Stimulation in Alzheimer’s Disease: A Meta-Analysis of Randomized Clinical Trials to Optimize Intervention Strategies

Neuroprotective effects of repetitive transcranial magnetic stimulation on Alzheimer's disease: Undetermined therapeutic protocols and mechanisms

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