Mano Tomoo
Department of Rehabilitation Medicine, Nara Medical University, Nara 634-8521, Japan.
Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan.
J Clin Med. 2022 Feb 1;11(3):798. doi: 10.3390/jcm11030798.
Repetitive transcranial magnetic stimulation (rTMS) is reportedly a potential tool to understand the neural network; however, the pathophysiological mechanisms underlying cognitive function change remain unclear. This study aimed to explore the cognitive function changes by rTMS over the bilateral dorsolateral prefrontal cortex (DLPFC) in Alzheimer's disease (AD). We evaluated the feasibility of rTMS application for mild cognitive dysfunction in patients with AD in an open-label trial (UMIN000027013). An rTMS session involved 15 trains at 120% resting motor threshold on each side (40 pulses/train at 10 Hz). Efficacy outcome measures were changes from baseline in cognitive function, assessed based on the AD Assessment Scale-cognitive subscale, Mini-Mental State Examination, Japanese version of Montreal Cognitive Assessment (MoCA-J), Behavioral and Psychological Symptom of Dementia, and Instrumental Activity of Daily Living scores. Sixteen patients with AD underwent five daily sessions of high-frequency rTMS over the bilateral DLPFC for 2 weeks. All participants completed the study; no major adverse effects were recorded. The MoCA-J score increased by 1.4 points (±0.15%) following 2 weeks of stimulation. At 1 month following rTMS cessation, all cognitive functional scores returned to the original state. Our findings suggest that the DLPFC plays an important role in the neural network in AD.
据报道,重复经颅磁刺激(rTMS)是一种了解神经网络的潜在工具;然而,认知功能变化背后的病理生理机制仍不清楚。本研究旨在探讨rTMS对阿尔茨海默病(AD)双侧背外侧前额叶皮质(DLPFC)的认知功能变化。我们在一项开放标签试验(UMIN000027013)中评估了rTMS应用于AD患者轻度认知功能障碍的可行性。一次rTMS治疗包括每侧以静息运动阈值的120%进行15组刺激(每组10赫兹,40个脉冲)。疗效结果指标是基于AD评估量表认知分量表、简易精神状态检查表、日本版蒙特利尔认知评估量表(MoCA-J)、痴呆的行为和心理症状以及日常生活活动能力得分,与基线相比认知功能的变化。16名AD患者在双侧DLPFC接受了为期2周、每天5次的高频rTMS治疗。所有参与者均完成了研究;未记录到重大不良反应。刺激2周后,MoCA-J评分提高了1.4分(±0.15%)。在rTMS停止后1个月,所有认知功能评分均恢复到原始状态。我们的研究结果表明,DLPFC在AD的神经网络中起重要作用。