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重复经颅磁刺激(rTMS)联合认知训练是治疗阿尔茨海默病的一种安全有效的方法:临床经验。

Repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training is a safe and effective modality for the treatment of Alzheimer's disease: clinical experience.

作者信息

Rabey Jose Martin, Dobronevsky Evgenia

机构信息

Department of Neurology, Assaf Harofeh Medical Center, 70300, Zerifin, Israel.

Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

J Neural Transm (Vienna). 2016 Dec;123(12):1449-1455. doi: 10.1007/s00702-016-1606-6. Epub 2016 Sep 8.

DOI:10.1007/s00702-016-1606-6
PMID:27631152
Abstract

Alzheimer's disease (AD) is the most common type of dementia among the elderly. Common treatments available and non-pharmacological interventions have their limitations, and new therapeutic approaches are critically needed. Transcranial magnetic stimulation (TMS) is a non-invasive technique that generates an electric current-inducing modulation in cortical excitability. The previous clinical trials showed that combinations of rTMS and cognitive training (rTMS-COG), as provided by the NeuroAD medical device system, offer a novel, safe, and effective method improving mild-to-moderate AD patients. In this article, we present our experience with rTMS-COG treatment, in clinical settings, of 30 mild-to-moderate AD patients that received rTMS-COG commercial treatments in two clinics for 1-h daily sessions, 5 days per week, for 6 weeks (30 sessions). Five patients returned for a second treatment. ADAS-Cog and MMSE scores were measured pre- and post-treatments. The main analyses were conducted on patients who received 1 treatment (n = 30). Data received from the five returning patients were analyzed separately. The effect of rTMS-COG treatment was statistically significant regarding both ADAS-Cog (-2.4 point improvement, PV <0.001) and MMSE (+1.7 points improvement, PV <0.001) scores. About 80 % of patients gained some cognitive improvement following NeuroAD treatment, with more than 60 % improving by more than two points, for a minimum of 9 months. The Neuronix NeuroAD System was shown to be a safe and effective non-invasive modality for cognitive improvement of Alzheimer patients, with measurable outcomes lasting, in some of them, for up to 1 year, following completion of the 6-week daily intervention course (a carryover effect).

摘要

阿尔茨海默病(AD)是老年人中最常见的痴呆类型。现有的常规治疗方法和非药物干预都有其局限性,因此迫切需要新的治疗方法。经颅磁刺激(TMS)是一种非侵入性技术,可在皮层兴奋性中产生感应电流调制。先前的临床试验表明,由NeuroAD医疗设备系统提供的重复经颅磁刺激与认知训练相结合(rTMS-COG),为改善轻至中度AD患者提供了一种新颖、安全且有效的方法。在本文中,我们介绍了在临床环境中对30例轻至中度AD患者进行rTMS-COG治疗的经验,这些患者在两家诊所接受了rTMS-COG商业治疗,每天治疗1小时,每周5天,共6周(30次治疗)。5名患者返回接受第二次治疗。在治疗前后测量了ADAS-Cog和MMSE评分。主要分析针对接受1次治疗的患者(n = 30)进行。对5名返回患者的数据进行了单独分析。rTMS-COG治疗对ADAS-Cog(改善2.4分,PV <0.001)和MMSE(改善1.7分,PV <0.001)评分的效果具有统计学意义。约80%的患者在接受NeuroAD治疗后获得了一定的认知改善,超过60%的患者改善超过2分,且至少持续9个月。在完成为期6周的每日干预疗程后,Neuronix NeuroAD系统被证明是一种安全有效的非侵入性方法,可改善阿尔茨海默病患者的认知,部分患者的可测量结果可持续长达1年(延迟效应)。

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