Abstract
Alzheimer’s disease (AD) is a severe neurodegenerative disease, which mainly manifests as memory and progressive cognitive impairment. At present, there is no method to prevent the progression of AD or cure it, and effective intervention methods are urgently needed. Network-targeted intermittent theta burst stimulation (iTBS) may be effective in alleviating the cognitive symptoms of patients with mild AD. The abnormal function of the dorsolateral prefrontal cortex (DLPFC) within executive control network (ECN) may be the pathogenesis of AD. Here, we verify the abnormality of the ECN in the native AD data set, and build the relevant brain network. In addition, we also recruited AD patients to verify the clinical effects of DLPFC-targeted intervention, and explor the neuro-mechanism. Sixty clinically diagnosed AD patients and 62 normal controls were recruited to explore the ECN abnormalities. In addition, the researchers recruited 20 AD patients to explore the efficacy of 14-session iTBS treatments for targeted DLPFC interventions. Functional magnetic resonance imaging and neuropsychological assessment of resting state were performed before and after the intervention. Calculate the changes in the functional connectivity of related brain regions in the ECN, as well as the correlation between the baseline functional connectivity and the clinical scoring scale, to clarify the mechanism of the response of iTBS treatment to treatment. Our results showed that compared with normal control samples, the brain function connection between the left DLPFC and the left IPL within the ECN of AD patients was significantly enhanced (t = 2.687, p = 0.008, FDR-corrected p = 0.045). And we found that iTBS stimulation significantly reduced the functional magnetic resonance imaging signal between the left DLPFC and the left IPL in the ECN (t = 4.271, p < 0.001, FDR-corrected p = 0.006), and it was related to the improvement of the patient’s clinical symptoms (r = −0.470, p = 0.042). This work provides new insights for targeted brain area interventions. By targeted adjusting the functional connection of ECN to improve the clinical symptoms and cognitive function of AD patients.
Highlights
Alzheimer’s disease (AD) is a severe neurodegenerative disease that mainly manifests as memory and progressive cognitive impairment (Molteni and Rossetti, 2017)
There were no significant differences in gender, age, and education between the AD and control groups
The results show that iTBS can significantly improve the overall cognitive function of AD patients, including MoCA (t = −5.229, p < 0.001), Mini-Mental State Examination (MMSE) (t = −5.3449, p < 0.001), CAVLT-immediately (t = −4.129, p < 0.001), CAVLT-delay (t = −4.129, p < 0.001), CAVLT-recognition (t = −3.256, p = 0.004) and Boston Naming Test (BNT) (t = −3.685, p = 0.002) significantly improved after stimulation
Summary
Alzheimer’s disease (AD) is a severe neurodegenerative disease that mainly manifests as memory and progressive cognitive impairment (Molteni and Rossetti, 2017). Data from the 2018 Annual Report of the World Alzheimer’s Disease (Prince and Matthew, 2018) show that there are approximately 50 million AD patients in the world at present, and the incidence continues to rise. AD has become the seventh cause of death in the world, and it is one of the most important health and social crises of the 21st century (Prince and Matthew, 2018). AD patients are mainly treated with drugs (Blennow et al, 2006), but these drug treatments can only delay the course of the disease to a certain extent, and they cause adverse reactions (Mielke et al, 2012). There is no method to prevent the progression of AD or cure it (Godyn et al, 2016). With the advancement of science and technology, physical therapy methods have gradually been applied to the field of neurodegenerative diseases, such as transcranial magnetic stimulation (TMS) and transcranial electrical stimulation
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