Anderkova Lubomira, Eliasova Ilona, Marecek Radek, Janousova Eva, Rektorova Irena
Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University (CEITEC MU), Brno, Czech Republic.
First Department of Neurology, St. Anne's University Hospital and School of Medicine, Masaryk University, Brno, Czech Republic.
J Alzheimers Dis. 2015;48(1):251-60. doi: 10.3233/JAD-150067.
Repetitive transcranial magnetic stimulation (rTMS) is a promising tool to study and modulate brain plasticity.
Our aim was to investigate the effects of rTMS on cognitive functions in patients with mild cognitive impairment and Alzheimer's disease (MCI/AD) and assess the effect of gray matter (GM) atrophy on stimulation outcomes.
Twenty MCI/AD patients participated in the proof-of-concept controlled study. Each patient received three sessions of 10 Hz rTMS of the right inferior frontal gyrus (IFG), the right superior temporal gyrus (STG), and the vertex (VTX, a control stimulation site) in a randomized order. Cognitive functions were tested prior to and immediately after each session. The GM volumetric data of patients were: 1) compared to healthy controls (HC) using source-based morphometry; 2) correlated with rTMS-induced cognitive improvement.
The effect of the stimulated site on the difference in cognitive scores was statistically significant for the Word part of the Stroop test (ST-W, p = 0.012, linear mixed models). As compared to the VTX stimulation, patients significantly improved after both IFG and STG stimulation in this cognitive measure. MCI/AD patients had significant GM atrophy in characteristic brain regions as compared to HC (p = 0.029, Bonferroni corrected). The amount of atrophy correlated with the change in ST-W scores after rTMS of the STG.
rTMS enhanced cognitive functions in MCI/AD patients. We demonstrated for the first time that distinct pattern of GM atrophy in MCI/AD diminishes the cognitive effects induced by rTMS of the temporal neocortex.
重复经颅磁刺激（rTMS）是一种用于研究和调节脑可塑性的有前景的工具。
我们的目的是研究rTMS对轻度认知障碍和阿尔茨海默病（MCI/AD）患者认知功能的影响，并评估灰质（GM）萎缩对刺激结果的影响。
20名MCI/AD患者参与了这项概念验证对照研究。每位患者以随机顺序接受对右侧额下回（IFG）、右侧颞上回（STG）和头顶（VTX，一个对照刺激部位）进行的3组10赫兹rTMS。在每组刺激之前和之后立即测试认知功能。患者的GM体积数据：1）使用基于源的形态测量法与健康对照（HC）进行比较；2）与rTMS诱导的认知改善相关。
对于Stroop测试的单词部分（ST-W，p = 0.012，线性混合模型），刺激部位对认知分数差异的影响具有统计学意义。与VTX刺激相比，在这一认知测量中，IFG和STG刺激后患者均有显著改善。与HC相比，MCI/AD患者在特征性脑区有显著的GM萎缩（p = 0.029，Bonferroni校正）。萎缩程度与STG进行rTMS后ST-W分数的变化相关。
rTMS增强了MCI/AD患者的认知功能。我们首次证明，MCI/AD中不同的GM萎缩模式会减弱颞叶新皮质rTMS诱导的认知效应。
