Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy.
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Brain Stimul. 2021 May-Jun;14(3):531-540. doi: 10.1016/j.brs.2021.03.007. Epub 2021 Mar 21.
OBJECTIVE: To assess whether exposure to non-invasive brain stimulation with transcranial alternating current stimulation at γ frequency (γ-tACS) applied over Pz (an area overlying the medial parietal cortex and the precuneus) can improve memory and modulate cholinergic transmission in mild cognitive impairment due to Alzheimer's disease (MCI-AD). METHODS: In this randomized, double-blind, sham controlled, crossover pilot study, participants were assigned to a single 60 min treatment with exposure to γ-tACS over Pz or sham tACS. Each subject underwent a clinical evaluation including assessment of episodic memory pre- and post-γ-tACS or sham stimulation. Indirect measures of cholinergic transmission evaluated using transcranial magnetic stimulation (TMS) pre- and post-γ-tACS or sham tACS were evaluated. RESULTS: Twenty MCI-AD participants completed the study. No tACS-related side effects were observed, and the intervention was well tolerated in all participants. We observed a significant improvement at the Rey auditory verbal learning (RAVL) test total recall (5.7 [95% CI, 4.0 to 7.4], p < 0.001) and long delayed recall scores (1.3 [95% CI, 0.4 to 2.1], p = 0.007) after γ-tACS but not after sham tACS. Face-name associations scores improved during γ-tACS (4.3 [95% CI, 2.8 to 5.8], p < 0.001) but not after sham tACS. Short latency afferent inhibition, an indirect measure of cholinergic transmission evaluated with TMS, increased only after γ-tACS (0.31 [95% CI, 0.24 to 0.38], p < 0.001) but not after sham tACS. CONCLUSIONS: exposure to γ-tACS over Pz showed a significant improvement of memory performances, along with restoration of intracortical connectivity measures of cholinergic neurotransmission, compared to sham tACS.
目的:评估经颅交流电刺激(transcranial alternating current stimulation,tACS)γ 频段(γ-tACS)刺激 Pz(覆盖内侧顶叶皮层和楔前叶的区域)是否可改善阿尔茨海默病相关轻度认知障碍(Alzheimer's disease,MCI-AD)患者的记忆,并调节胆碱能传递。
方法:在这项随机、双盲、假刺激对照、交叉先导研究中,参与者被分配至单次 60 分钟 Pz 区γ-tACS 或假 tACS 暴露治疗。所有受试者均接受临床评估,包括γ-tACS 或假刺激前后的情景记忆评估。γ-tACS 或假 tACS 前后采用经颅磁刺激(transcranial magnetic stimulation,TMS)评估间接的胆碱能传递测量。
结果:20 名 MCI-AD 参与者完成了这项研究。未观察到 tACS 相关的不良反应,所有参与者均能很好地耐受干预。我们观察到,与假 tACS 相比,γ-tACS 后 Rey 听觉言语学习测试(Rey auditory verbal learning test,RAVL)总回忆(5.7[95%置信区间,4.0 至 7.4],p<0.001)和长延迟回忆评分(1.3[95%置信区间,0.4 至 2.1],p=0.007)显著改善。γ-tACS 后面孔-名字关联测试(face-name associations test)评分改善(4.3[95%置信区间,2.8 至 5.8],p<0.001),但假 tACS 后无改善。用 TMS 评估的胆碱能传递的短潜伏期传入抑制,一种间接的测量指标,仅在γ-tACS 后增加(0.31[95%置信区间,0.24 至 0.38],p<0.001),但假 tACS 后无增加。
结论:与假 tACS 相比,γ-tACS 刺激 Pz 可显著改善记忆表现,并恢复胆碱能神经传递的皮质内连接测量。
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