Transcranial magnetic stimulation cortical oscillations and improve cognition in obstructive sleep apnea patients

Abstract

Background Transcranial magnetic stimulation (TMS) is a noninvasive tool to improve cognition. Relevant clinical studies are mainly focused on neurological and psychiatric diseases. However, cognition decline and psychiatric disorders are popular in obstructive sleep apnea (OSA) patients. We aimed to investigate the effect of TMS over the left dorsolateral prefrontal cortex (DLPFC) on cognition test performance and to compare the changes in quantitative electroencephalogram (EEG) before and after stimulation for OSA. Methods This study recruited 42 OSA patients diagnosed with polysomnography according to American Academy of Sleep Medicine guidelines. TMS (intermittent theta‐burst stimulation paradigm; 2 s on, 8 s off, 600 pulses*3, intermittent 15 min) was performed on the DLPFC. Cambridge Automated Neuropsychological Test Battery was used to assess cognitive performance. EEG oscillations were computed via power spectral density with MATLAB software. Results Real‐TMS group displayed a significant improvement in visual memory, sustain attention performance, as well as the outcome of working memory. However, the executive function of latency was changed in both groups. Furthermore, TMS resulted in a significant increase in the relative power spectral density of the theta band and beta band in the parietal, temporal, and anterior regions, respectively. Conclusions In summary, our findings indicate that TMS can safely modulate cortical oscillations and improve cognition in OSA patients. In the future, TMS can be utilized as an alternative treatment option to improve cognition in OSA patients.

The Use of Cognitive Paired Associative Stimulation (C-PAS) in Investigating and Remediating the Effects of Sleep Deprivation on Working Memory in Humans: The Importance of State-Dependency

“…In another recent report, sleep deprivation in healthy adults prevented the LTP-like effects of anodal tDCS from occurring while reversing the LDP-like effects of cathodal tDCS, both of which can impact cognitive performance [35]. Using TMS in a clinical setting with sleep-deprived patients has also resulted in cognitive improvements: in a group of 42 patients suffering from obstructive sleep apnea, a session of a form of TMS known as intermittent theta burst stimulation resulted in significant improvements in performance in working memory, sustained attention, and visual memory tasks [36]. Overall, when added to the initial results of significant working memory performance enhancements [17••, 24••], these other findings from noninvasive magnetic and electric brain stimulation techniques reinforce the promise of TMS as a means of remediating the deficits in cognition, especially in working memory, caused by sleep deprivation.…”