Mimenza-Alvarado Alberto José, Aguilar-Navarro Sara Gloria, Martinez-Carrillo Francisco M, Ríos-Ponce Alma E, Villafuerte Gabriel
Department of Geriatric Medicine & Neurology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Clínica Coyoacán, Mexico City, Mexico.
Front Neurol. 2021 Sep 9;12:729872. doi: 10.3389/fneur.2021.729872. eCollection 2021.
Alzheimer's disease (AD) animal models have shown a reduced gamma power in several brain areas, and induction of these oscillations by non-invasive methods has been shown to modify several pathogenic mechanisms of AD. In humans, the application of low-intensity magnetic fields has shown to be able to produce neural entrainment at the magnetic pulse frequency, making it useful to induce gamma frequencies. The aim of this study was to assess if the application of fast gamma magnetic stimulation (FGMS) over the left prefrontal dorsolateral cortex would be a safe and well-tolerated intervention that could potentially improve cognitive scores in subjects with mild cognitive impairment and mild AD. In these randomized, double-blind, sham-controlled study, participants were assigned to either receive daily sessions two times a day of active or sham FGMS for 6 months. Afterward, measurements of adverse effects, cognition, functionality, and depression were taken. Thirty-four patients, 17 in each group, were analyzed for the primary outcome. FGMS was adequately tolerated by most of the subjects. Only four patients from the active FGMS group (23.52%) and one patient from the sham FGMS group (5.88%) presented any kind of adverse effects, showing no significant difference between groups. Nevertheless, FGMS did not significantly change cognitive, functionality, or depressive evaluations. FGMS over the left prefrontal dorsolateral cortex applied twice a day for 6 months resulted to be a viable intervention that can be applied safely directly from home without supervision of a healthcare provider. However, no statistically significant changes in cognitive, functionality, or depression scores compared to sham stimulation were observed. www.ClinicalTrials.gov, Identifier: NCT03983655, URL: https://clinicaltrials.gov/ct2/show/NCT03983655.
阿尔茨海默病(AD)动物模型显示,多个脑区的γ波功率降低,并且已证明通过非侵入性方法诱导这些振荡能够改变AD的几种致病机制。在人类中,低强度磁场的应用已显示能够在磁脉冲频率下产生神经夹带,从而有助于诱导γ频率。本研究的目的是评估在左侧前额叶背外侧皮质施加快速γ磁刺激(FGMS)是否是一种安全且耐受性良好的干预措施,有可能改善轻度认知障碍和轻度AD患者的认知评分。在这项随机、双盲、假对照研究中,参与者被分配为每天接受两次主动或假FGMS治疗,为期6个月。之后,对不良反应、认知、功能和抑郁进行测量。对34名患者(每组17名)进行了主要结局分析。大多数受试者对FGMS耐受性良好。主动FGMS组只有4名患者(23.52%)和假FGMS组只有1名患者(5.88%)出现了任何类型的不良反应,两组之间无显著差异。然而,FGMS并未显著改变认知、功能或抑郁评估。每天两次在左侧前额叶背外侧皮质施加FGMS,持续6个月,结果表明这是一种可行的干预措施,可以在无需医疗保健提供者监督的情况下直接在家中安全应用。然而,与假刺激相比,未观察到认知、功能或抑郁评分有统计学显著变化。ClinicalTrials.gov,标识符:NCT03983655,网址:https://clinicaltrials.gov/ct2/show/NCT03983655 。