Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA; Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Psychiatry Res. 2018 Mar;261:312-318. doi: 10.1016/j.psychres.2017.12.063. Epub 2018 Jan 5.
Apathy is a common and disabling behavioral concomitant of many neurodegenerative conditions. The presence of apathy with Mild Cognitive Impairment (MCI) is linked with heightened rates of conversion to Alzheimer's disease. Improving apathy may slow the neurodegenerative process. The objective was to establish the efficacy of repetitive transcranial magnetic stimulation (rTMS) in improving apathy in older adults with MCI. An 8-week, double-blind, randomized, sham-controlled cross-over study was conducted in nine subjects (66 ± 9 years) with apathy and MCI. Subjects were randomized to rTMS or sham treatment (5 days/week) for 2 weeks following which they underwent a 4-week treatment-free period. Subjects then crossed-over to receive the other treatment for 2 weeks. The primary (apathy (AES-C)) and secondary (cognition (3MS & MMSE), executive function (TMT-A & TMT-B), and clinical global impression (CGI)) outcomes were assessed at baseline, 2, 6, and 8 weeks. After adjusting for baseline, there was a significantly greater improvement in the AES-C with rTMS compared to sham treatment at 2 weeks. There was significantly greater improvement in 3MS, MMSE, TMT-A, and CGI-I with rTMS compared to the sham treatment. This study establishes that rTMS is efficacious in improving apathy in subjects with MCI.
冷漠是许多神经退行性疾病的常见且致残的行为伴随症状。轻度认知障碍 (MCI) 伴冷漠与阿尔茨海默病转化率升高有关。改善冷漠可能会减缓神经退行性过程。目的是确定重复经颅磁刺激 (rTMS) 在改善患有 MCI 的老年人冷漠方面的疗效。在 9 名患有冷漠和 MCI 的受试者（66±9 岁）中进行了为期 8 周的双盲、随机、假对照交叉研究。受试者随机接受 rTMS 或假治疗（每周 5 天）2 周，然后进行 4 周的无治疗期。然后，受试者交叉接受另一种治疗 2 周。主要（冷漠（AES-C））和次要（认知（3MS 和 MMSE）、执行功能（TMT-A 和 TMT-B）和临床总体印象（CGI））结果在基线、2、6 和 8 周时进行评估。在调整基线后，rTMS 在 2 周时与假治疗相比，AES-C 的改善明显更大。rTMS 与假治疗相比，3MS、MMSE、TMT-A 和 CGI-I 的改善明显更大。这项研究表明 rTMS 对改善 MCI 患者的冷漠是有效的。
