Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy.
NeuroTeam Life and Science, Palermo, Italy.
J Alzheimers Dis. 2019;72(2):613-622. doi: 10.3233/JAD-190888.
The lack of effective pharmacological or behavioral interventions for memory impairments associated with Alzheimer's disease (AD) emphasizes the need for the investigation of approaches based on neuromodulation.
This study examined the effects of inhibitory repetitive transcranial magnetic stimulation (rTMS) of prefrontal cortex on recognition memory in AD patients.
In a first experiment, 24 mild AD patients received sham and real 1Hz rTMS over the left and right dorsolateral prefrontal cortex (DLPFC), in different sessions, between encoding and retrieval phases of a non-verbal recognition memory task. In a second experiment, another group of 14 AD patients underwent sham controlled repeated sessions of 1Hz rTMS of the right DLPFC across a two week treatment. Non-verbal recognition memory task was performed at baseline, at the end of the two weeks period and at a follow up of 1 month.
Right real rTMS significantly improved memory performance compared to right sham rTMS (p = 0.001). Left real rTMS left the memory performance unchanged as compared with left sham rTMS (p = 0.46). The two sham conditions did not differ between each other (p = 0.24). In the second experiment, AD patients treated with real rTMS showed an improvement of memory performance at the end of the two weeks treatment (p = 0.0009), that persisted at 1-month follow-up (p = 0.002).
These findings provide evidence that inhibitory rTMS over the right DLPFC can improve recognition memory function in AD patients. They also suggest the importance of a new approach of non-invasive brain stimulation as a promising treatment in AD.
缺乏针对阿尔茨海默病(AD)相关记忆障碍的有效药物或行为干预措施,强调了需要研究基于神经调节的方法。
本研究考察了抑制性经颅重复磁刺激(rTMS)对 AD 患者识别记忆的影响。
在第一个实验中,24 名轻度 AD 患者在编码和检索阶段之间,分别在左、右侧背外侧前额叶(DLPFC)接受假刺激和真刺激 1Hz rTMS。在第二个实验中,另一组 14 名 AD 患者在两周治疗期间接受右侧 DLPFC 的假控制重复 1Hz rTMS。在基线、两周治疗结束和一个月随访时进行非言语识别记忆任务。
与右侧假刺激 rTMS 相比,右侧真刺激 rTMS 显著改善了记忆表现(p=0.001)。与左侧假刺激 rTMS 相比,左侧真刺激 rTMS 对记忆表现没有影响(p=0.46)。两种假刺激条件之间没有差异(p=0.24)。在第二个实验中,接受真刺激 rTMS 的 AD 患者在两周治疗结束时记忆表现有所改善(p=0.0009),并在一个月随访时持续改善(p=0.002)。
这些发现提供了证据表明,右侧 DLPFC 的抑制性 rTMS 可以改善 AD 患者的识别记忆功能。它们还表明,非侵入性脑刺激的新方法作为 AD 的一种有前途的治疗方法具有重要意义。