IRCCS Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia 25125, Italy.
J Neurol Neurosurg Psychiatry. 2011 Jul;82(7):794-7. doi: 10.1136/jnnp.2009.197848. Epub 2010 Jun 23.
Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a possible treatment for the cognitive deficits associated with Alzheimer disease (AD). The aim of this study was to assess the long-term effects, on cognitive performance, of rTMS applied to the left dorsolateral prefrontal cortex (DLPFC) in AD patients.
Ten AD patients were randomly assigned to one of two study groups. Multiple-baseline design was used.The first group underwent a 4-week real rTMS stimulation protocol, while the second underwent a 2-week placebo treatment, followed by 2 weeks of real rTMS stimulation. Each session consisted of the application of rhythmic high-frequency rTMS over the DLPFC for 25 min. Sessions occurred once daily, 5 days/week. The main analysed outcome was the change in cognitive test performance at 2 and 4 weeks after rTMS treatment initiation, with a follow-up performed 8 weeks after the end of rTMS, in comparison with baseline performance.
A significant difference was found between groups over sessions in terms of the percentage of correct responses of auditory sentence comprehension. Only real treatment induced an improvement in performance with respect to baseline or placebo. Moreover, both groups showed a lasting effect on the improved performance 8 weeks after the end of treatment.
The findings provide initial evidence for the persistent beneficial effects of rTMS on sentence comprehension in AD patients. Rhythmic rTMS, in conjunction with other therapeutic interventions, may represent a novel approach to the treatment of language dysfunction in AD patients.
重复经颅磁刺激(rTMS)已被提议作为治疗与阿尔茨海默病(AD)相关认知缺陷的一种可能方法。本研究的目的是评估 rTMS 应用于 AD 患者左背外侧前额叶(DLPFC)对认知表现的长期影响。
10 名 AD 患者被随机分配到两个研究组之一。采用多基线设计。第一组接受为期 4 周的真实 rTMS 刺激方案,第二组接受为期 2 周的安慰剂治疗,然后进行 2 周的真实 rTMS 刺激。每个疗程包括在 DLPFC 上进行 25 分钟的节律性高频 rTMS 应用。每天一次,每周 5 天。主要分析结果是 rTMS 治疗开始后 2 周和 4 周时认知测试表现的变化,并在 rTMS 治疗结束后 8 周进行随访,与基线表现进行比较。
在疗程中,听觉句子理解的正确反应百分比方面,组间存在显著差异。只有真实治疗相对于基线或安慰剂改善了表现。此外,两组在治疗结束后 8 周都显示出对改善表现的持久影响。
这些发现为 rTMS 对 AD 患者句子理解的持续有益影响提供了初步证据。节律性 rTMS 结合其他治疗干预措施,可能成为治疗 AD 患者语言功能障碍的一种新方法。