Antczak Jakub, Kowalska Katarzyna, Klimkowicz-Mrowiec Aleksandra, Wach Barbara, Kasprzyk Katarzyna, Banach Marta, Rzeźnicka-Brzegowy Karolina, Kubica Jadwiga, Słowik Agnieszka
Department of Neurology, Jagiellonian University Medical College, Kraków, Poland.
Department of Neurology, 5th Military Hospital with Polyclinic in Cracow, Kraków, Poland.
Neuropsychiatr Dis Treat. 2018 Mar 13;14:749-755. doi: 10.2147/NDT.S153213. eCollection 2018.
Frontotemporal dementia (FTD) is one of the most frequent dementia types in patients under 65 years of age. Currently, no therapy can effectively improve the cognitive deficits associated with FTD. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive method of inducing brain plasticity with therapeutic potential in neurodegenerative diseases. The purpose of this study was to evaluate the effect of rTMS on cognitive, behavioral, and emotional function in FTD.
Nine patients (seven women, four men, mean age 61.7±10.1 years) with the behavioral variant of FTD, one with nonfluent/agrammatic variant primary progressive aphasia, and one with progressive nonfluent aphasia (subtypes of FTD) underwent 10 daily sessions of 10 Hz rTMS over the bilateral dorsolateral prefrontal cortex. Cognitive and behavioral assessments were administered before and after therapy.
After rTMS, the Montreal Cognitive Assessment and letter and digit cancellation test scores, as well as reading time and error number in the Stroop test improved. The caregivers' impression of the daily functioning of patients improved in the Frontal Behavioral Inventory scores. These changes were not paralleled by an improvement of mood.
The results indicate that rTMS may improve the cognitive performance of patients with FTD and warrant sham-controlled trials.
额颞叶痴呆（FTD）是65岁以下患者中最常见的痴呆类型之一。目前，尚无治疗方法能有效改善与FTD相关的认知缺陷。重复经颅磁刺激（rTMS）是一种诱导脑可塑性的非侵入性方法，在神经退行性疾病中具有治疗潜力。本研究的目的是评估rTMS对FTD患者认知、行为和情感功能的影响。
9例行为变异型FTD患者（7例女性，4例男性，平均年龄61.7±10.1岁）、1例非流利/语法缺失变异型原发性进行性失语患者和1例进行性非流利性失语患者（FTD的亚型）接受了为期10天、每天对双侧背外侧前额叶皮层进行10 Hz rTMS的治疗。在治疗前后进行认知和行为评估。
rTMS治疗后，蒙特利尔认知评估、字母和数字划消测试得分以及斯特鲁普测试中的阅读时间和错误数均有所改善。在额叶行为量表得分方面，照料者对患者日常功能的印象有所改善。但这些变化并未伴随着情绪的改善。
结果表明，rTMS可能改善FTD患者的认知表现，值得进行假对照试验。
