Synergistic effects of rTMS and cognitive training in Alzheimer's Disease

Brem, Anna-Katharine; Schilberg, Lukas; Freitas, Catarina; Atkinson, Natasha; Seligson, Erica; Pascual‐Leone, Álvaro

doi:10.1016/j.jns.2013.07.1265

Cited by 3 publications

(19 citation statements)

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“…Of these studies, nine were RCTs with a parallel control design and four had a crossover design. The data from seven parallel‐group RCTs with complete outcome data (Cotelli et al , ; Ahmed et al , ; Brem et al , ; Rabey et al , ; Drumond Marra et al , ; Wu et al , ; Lee et al , ) were synthesised in the meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Only two studies targeted subjects with MCI (Turriziani et al , ; Drumond Marra et al , ). In three studies, no concomitant psychotropic medication was used (Ahmed et al , ; Turriziani et al , ; Drumond Marra et al , ); in seven studies, the participants took cognition‐enhancing drugs for dementia (Cotelli et al , ; Cotelli et al , ; Brem et al , ; Rabey et al , ; Ash et al , ; Rutherford et al , ; Lee et al , ); and in one study, risperidone was used to control behavioural and psychological symptoms of dementia (Wu et al , ) (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Most studies used a figure‐of‐eight coil, one study used an H‐coil (Coppi et al , ) and three studies did not report which type of coil was used (Ash et al , ; Rutherford et al , ; Lee et al , ). All studies involved the frontal/prefrontal region as the TMS target sites: seven studies used the DLPFC as the sole target (either unilaterally or bilaterally) (Cotelli et al , ; Cotelli et al , ; Ahmed et al , ; Turriziani et al , ; Drumond Marra et al , ; Rutherford et al , ; Wu et al , ); three studies targeted the same combination of sites involving Broca's area, Wernicke's area, the DLPFC and the parietal cortex (Brem et al , ; Rabey et al , ; Lee et al , ). Coppi et al () and Ash et al () reported using the fronto‐parietal–temporal lobes and prefrontal areas, respectively, without specifying the exact target site.…”

Section: Resultsmentioning

confidence: 99%

“…In addition to the assessments before and immediately after the intervention, eight studies also assessed the effects of TMS at follow‐up periods from 1 to 4.5 months. Four studies examined the effects of TMS combined with cognitive training; three used similar systems (NeuroAD System, Neuronix Ltd., Yokneam, Israel) to combine TMS and cognitive training in an interlaced fashion (Brem et al , ; Rabey et al , ; Lee et al , ); and one instructed its participants to perform cognitive training between the pulse trains (Rutherford et al , ) (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Table lists the methodological qualities of the seven trials included in the meta‐analysis. There was limited information to assess the risk of bias of Brem et al () because it was published as an abstract. Although all included trials were reported to be randomised, only two studies reported adequate sequence randomisation with the use of a random number generator or a random number table (Drumond Marra et al , ; Wu et al , ).…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Effects of repetitive transcranial magnetic stimulation on improvement of cognition in elderly patients with cognitive impairment: a systematic review and meta‐analysis

Cheng

Wong

Lee

et al. 2017

Int J Geriat Psychiatry

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Objective: This systematic review and meta-analysis aimed to examine the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive function in older patients with cognitive impairment. Methods: A literature search was performed for articles published in English using the 10 databases (MEDLINE, EMBASE, PsycINFO, INSPEC, the Cumulative Index to Nursing and Allied Health Literature Plus, AMED, Biological Sciences, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews) from their inception to May 2016. The primary outcome was cognitive function as measured by the Mini-Mental State Examination or the Alzheimer's Disease Assessment Scale-cognitive subscale. Results: Seven RCTs were included in the meta-analysis, with a sample of 107 active and 87 sham rTMS. Active rTMS was found to be more effective in improving cognition (Hedges' g = 0.48; 95% confidence interval 0.12 to 0.84). Conclusions: High-frequency rTMS showed a benefit on cognition amongst older patients with mild to moderate Alzheimer's disease. rTMS was shown to have great potential as a safe and well-tolerated alternative intervention for cognition.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Effects of repetitive transcranial magnetic stimulation on improvement of cognition in elderly patients with cognitive impairment: a systematic review and meta‐analysis

Cheng

Wong

Lee

et al. 2017

Int J Geriat Psychiatry

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Effects of a combined transcranial magnetic stimulation (TMS) and cognitive training intervention in patients with Alzheimer's disease

Sabbagh

Sadowsky

Tousi

et al. 2020

Alzheimer's & Dementia

109

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Introduction This clinical trial evaluates the efficacy and safety of a 6‐week course of daily neuroAD™ therapy. Methods 131 subjects between 60 and 90 years old, unmedicated for Alzheimer's disease (AD), or on stable doses of an acetylcholinesterase inhibitor and/or memantine, with Mini–Mental State Examination scores between 18 and 26, clinical dementia rating scale scores of 1 or 2, enrolled for a prospective, randomized, double‐blind, sham‐controlled, multicenter clinical trial. Structural brain MRIs were obtained for transcranial magnetic stimulation targeting. Baseline Alzheimer's disease assessment scale—cognitive (ADAS‐Cog) and Clinical Global Impression of Change were assessed. 129 participants were randomized to active treatment plus standard of care (SOC) or sham treatments plus SOC. Results Subjects with baseline ADAS‐Cog ≤ 30 (~85% of study population) showed a statistically significant benefit favoring active over sham. Responder analysis showed 31.7% participants in the active group with ≤ −4 point improvement on ADAS‐Cog versus 15.4% in the sham group. Discussion neuroAD™ Therapy System provides a low‐risk therapeutic benefit for patients with milder AD (baseline ADAS‐Cog ≤30) beyond pharmacologic SOC.

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

Sanches

Stengel

Godard

et al. 2021

Front. Aging Neurosci.

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Low birth rates and increasing life expectancy experienced by developed societies have placed an unprecedented pressure on governments and the health system to deal effectively with the human, social and financial burden associated to aging-related diseases. At present, ∼24 million people worldwide suffer from cognitive neurodegenerative diseases, a prevalence that doubles every five years. Pharmacological therapies and cognitive training/rehabilitation have generated temporary hope and, occasionally, proof of mild relief. Nonetheless, these approaches are yet to demonstrate a meaningful therapeutic impact and changes in prognosis. We here review evidence gathered for nearly a decade on non-invasive brain stimulation (NIBS), a less known therapeutic strategy aiming to limit cognitive decline associated with neurodegenerative conditions. Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation, two of the most popular NIBS technologies, use electrical fields generated non-invasively in the brain to long-lastingly enhance the excitability/activity of key brain regions contributing to relevant cognitive processes. The current comprehensive critical review presents proof-of-concept evidence and meaningful cognitive outcomes of NIBS in eight of the most prevalent neurodegenerative pathologies affecting cognition: Alzheimer’s Disease, Parkinson’s Disease, Dementia with Lewy Bodies, Primary Progressive Aphasias (PPA), behavioral variant of Frontotemporal Dementia, Corticobasal Syndrome, Progressive Supranuclear Palsy, and Posterior Cortical Atrophy. We analyzed a total of 70 internationally published studies: 33 focusing on Alzheimer’s disease, 19 on PPA and 18 on the remaining neurodegenerative pathologies. The therapeutic benefit and clinical significance of NIBS remains inconclusive, in particular given the lack of a sufficient number of double-blind placebo-controlled randomized clinical trials using multiday stimulation regimes, the heterogeneity of the protocols, and adequate behavioral and neuroimaging response biomarkers, able to show lasting effects and an impact on prognosis. The field remains promising but, to make further progress, research efforts need to take in account the latest evidence of the anatomical and neurophysiological features underlying cognitive deficits in these patient populations. Moreover, as the development of in vivo biomarkers are ongoing, allowing for an early diagnosis of these neuro-cognitive conditions, one could consider a scenario in which NIBS treatment will be personalized and made part of a cognitive rehabilitation program, or useful as a potential adjunct to drug therapies since the earliest stages of suh diseases. Research should also integrate novel knowledge on the mechanisms and constraints guiding the impact of electrical and magnetic fields on cerebral tissues and brain activity, and incorporate the principles of information-based neurostimulation.

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Synergistic effects of rTMS and cognitive training in Alzheimer's Disease

Cited by 3 publications

References 0 publications

Effects of repetitive transcranial magnetic stimulation on improvement of cognition in elderly patients with cognitive impairment: a systematic review and meta‐analysis

Effects of repetitive transcranial magnetic stimulation on improvement of cognition in elderly patients with cognitive impairment: a systematic review and meta‐analysis

Effects of a combined transcranial magnetic stimulation (TMS) and cognitive training intervention in patients with Alzheimer's disease

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

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