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影响重复经颅磁刺激治疗阿尔茨海默病患者疗效的因素。

Factors affecting the efficacy of repetitive transcranial magnetic stimulation for patients with Alzheimer's disease.

机构信息

Department of Psychiatry.

出版信息

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2021 Jun 25;50(3):383-389. doi: 10.3724/zdxbyxb-2021-0184.

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a safe and non-invasive technique. In recent years, many studies have demonstrated that rTMS can improve cognitive function in Alzheimer's disease (AD) patients and has potential as a therapeutic method for AD. However, the efficacy varies greatly with different rTMS treatment regimens, which is related to the frequency, type, location, duration, intensity and focusing power of stimulation. Recent studies have shown that high-frequency stimulation is superior to low-frequency stimulation; efficacy of intermittent theta burst stimulation (iTBS) is similar to that of conventional rTMS, but iTBS treatment session is shorter and might be more acceptable for AD patients; rTMS stimulation sites targeting AD-damaged brain regions or associated networks would be more effective; short-term intensive treatment combined with long-term maintenance treatment can gain long-term efficacy; dynamic adjustment of stimulus intensity combined with the degree of cognitive impairment can enhance the efficacy; functional connection based on functional magnetic resonance imaging may improve the focusing power of rTMS. In this article, we review the factors related to the efficacy of rTMS, to provide reference for feasible rTMS therapeutic regimens of AD.

摘要

重复经颅磁刺激(rTMS)是一种安全、非侵入性的技术。近年来,许多研究表明 rTMS 可改善阿尔茨海默病(AD)患者的认知功能,具有作为 AD 治疗方法的潜力。然而,不同 rTMS 治疗方案的疗效差异很大,这与刺激的频率、类型、位置、持续时间、强度和聚焦能力有关。最近的研究表明,高频刺激优于低频刺激;间歇性经颅磁刺激(iTBS)的疗效与传统 rTMS 相似,但 iTBS 治疗疗程更短,可能更受 AD 患者的欢迎;针对 AD 损伤脑区或相关网络的 rTMS 刺激部位更有效;短期强化治疗结合长期维持治疗可获得长期疗效;结合认知障碍程度的刺激强度动态调整可增强疗效;基于功能磁共振成像的功能连接可能会提高 rTMS 的聚焦能力。本文综述了 rTMS 疗效相关的影响因素,以期为 AD 可行的 rTMS 治疗方案提供参考。

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Factors affecting the efficacy of repetitive transcranial magnetic stimulation for patients with Alzheimer's disease.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2021 Jun 25;50(3):383-389. doi: 10.3724/zdxbyxb-2021-0184.

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Cortical plasticity is correlated with cognitive improvement in Alzheimer's disease patients after rTMS treatment.
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Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018).
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