Abstract
ObjectiveWe aim to study the effect of precision repetitive transcranial magnetic stimulation (rTMS) over the left parietal cortex on the memory and cognitive function in Alzheimer’s disease (AD).MethodsBased on the resting-state functional magnetic resonance imaging, the left parietal cortex site with the highest functional connectivity to the hippocampus was selected as the target of rTMS treatment. Sixty-nine AD patients were randomized to either rTMS or sham treatment (five sessions/week for a total of 10 sessions). The Mini-Mental State Examination (MMSE), 12-Word Philadelphia Verbal Learning Test (PVLT), and Clinical Dementia Rating (CDR) were assessed at baseline and after the last session.ResultsAfter a 2-week treatment, compared to patients in the sham group, those in the rTMS group scored significantly higher on PVLT total score and its immediate recall subscale score. Moreover, in the rTMS group, there were significant improvements after the 2-week treatment, which were manifested in MMSE total score and its time orientation and recall subscale scores, as well as PVLT total score and its immediate recall and short delay recall subscale scores. In the sham group, the PVLT total score was significantly improved.ConclusionThe target site of the left parietal cortex can improve AD patients’ cognitive function, especially memory, providing a potential therapy.
Highlights
Alzheimer’s disease (AD), the most common subtype of dementia among elderly adults (Sosa-Ortiz et al, 2012; Fargo et al, 2014), is generally characterized by memory decline, language dysfunctions, mood and personality changes, loss of spatial and temporal orientation, and behavioral derangements, leading to impaired functioning in individuals’ occupational and social domains (Lane et al, 2018)
We aim to study the effect of precision repetitive transcranial magnetic stimulation over the left parietal cortex on the memory and cognitive function in Alzheimer’s disease (AD)
In the repetitive transcranial magnetic stimulation (rTMS) group, there were significant improvements after the 2-week treatment, which were manifested in MiniMental State Examination (MMSE) total score and its time orientation and recall subscale scores, as well as Philadelphia Verbal Learning Test (PVLT) total score and its immediate recall and short delay recall subscale scores
Summary
Alzheimer’s disease (AD), the most common subtype of dementia among elderly adults (Sosa-Ortiz et al, 2012; Fargo et al, 2014), is generally characterized by memory decline (the core symptom), language dysfunctions, mood and personality changes, loss of spatial and temporal orientation, and behavioral derangements, leading to impaired functioning in individuals’ occupational and social domains (Lane et al, 2018). AD is mainly treated by focusing on decelerating cognition decline using clinically approved medications, such as cholinesterase inhibitors, including donepezil, rivastigmine, and galantamine, for mild and moderate AD (Birks, 2006), and memantine, a medication antagonizing the N-methyl-Daspartate receptor, for moderate and severe AD (McShane et al, 2019) These medications can only be used for symptomatic treatment, with limited efficacy, and cannot prevent disease course (Fargo et al, 2014; Anand et al, 2017; Lane et al, 2018), and not all patients can tolerate it. As a consequence, exploring some non-pharmacological therapeutic strategies is highly demanding
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