Guo Yi, Dang Ge, Hordacre Brenton, Su Xiaolin, Yan Nan, Chen Siyan, Ren Huixia, Shi Xue, Cai Min, Zhang Sirui, Lan Xiaoyong
Department of Neurology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.
Shenzhen Bay Laboratory, Shenzhen, China.
Front Aging Neurosci. 2021 Jul 7;13:679585. doi: 10.3389/fnagi.2021.679585. eCollection 2021.
Increasing evidence demonstrates that repetitive transcranial magnetic stimulation (rTMS) treatment of the dorsolateral prefrontal cortex is beneficial for improving cognitive function in patients with Alzheimer's disease (AD); however, the underlying mechanism of its therapeutic effect remains unclear. The aim of this study was to investigate the impact of rTMS to the dorsolateral prefrontal cortex on functional connectivity along with treatment response in AD patients with different severity of cognitive impairment. We conducted a 2-week treatment course of 10-Hz rTMS over the left dorsolateral prefrontal cortex in 23 patients with AD who were split into the mild or moderate cognitive impairment subgroup. Resting state electroencephalography and general cognition was assessed before and after rTMS. Power envelope connectivity was used to calculate functional connectivity at the source level. The functional connectivity of AD patients and 11 cognitively normal individuals was compared. Power envelope connectivity was higher in the delta and theta bands but lower in the beta band in the moderate cognitive impairment group, compared to the cognitively normal controls, at baseline ( < 0.05). The mild cognitive impairment group had no significant abnormities. Montreal Cognitive Assessment scores improved after rTMS in the moderate and mild cognitive impairment groups. Power envelope connectivity in the beta band post-rTMS was increased in the moderate group ( < 0.05) but not in the mild group. No significant changes in the delta and theta band were found after rTMS in both the moderate and mild group. High-frequency rTMS to the dorsolateral prefrontal cortex modulates electroencephalographic functional connectivity while improving cognitive function in patients with AD. Increased beta connectivity may have an important mechanistic role in rTMS therapeutic effects.
越来越多的证据表明,重复经颅磁刺激(rTMS)治疗背外侧前额叶皮质对改善阿尔茨海默病(AD)患者的认知功能有益;然而,其治疗效果的潜在机制仍不清楚。本研究的目的是调查rTMS对背外侧前额叶皮质的刺激对不同认知障碍严重程度的AD患者功能连接性以及治疗反应的影响。我们对23例AD患者进行了为期2周的左侧背外侧前额叶皮质10赫兹rTMS治疗疗程,这些患者被分为轻度或中度认知障碍亚组。在rTMS治疗前后评估静息态脑电图和总体认知情况。采用功率包络连接性来计算源水平的功能连接性。比较了AD患者和11名认知正常个体的功能连接性。与认知正常对照组相比,中度认知障碍组在基线时,δ波和θ波频段的功率包络连接性较高,而β波频段较低(P<0.05)。轻度认知障碍组无明显异常。在中度和轻度认知障碍组中,rTMS治疗后蒙特利尔认知评估得分有所改善。中度组rTMS治疗后β波频段的功率包络连接性增加(P<0.05),而轻度组没有增加。在中度和轻度组中,rTMS治疗后δ波和θ波频段均未发现显著变化。对背外侧前额叶皮质进行高频rTMS可调节脑电图功能连接性,同时改善AD患者的认知功能。β连接性增加可能在rTMS治疗效果中起重要的机制作用。
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