Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, USA; Evelyn F McKnight Brain Institute, Arizona Center on Aging, and BIO5 Institute, University of Arizona, Tucson, USA.
Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, USA.
Ageing Res Rev. 2022 Aug;79:101660. doi: 10.1016/j.arr.2022.101660. Epub 2022 Jun 6.
Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique. When stimulation is applied over the primary motor cortex and coupled with electromyography measures, TMS can probe functions of cortical excitability and plasticity in vivo. The purpose of this meta-analysis is to evaluate the utility of TMS-derived measures for differentiating patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) from cognitively normal older adults (CN).
Databases searched included PubMed, Embase, APA PsycInfo, Medline, and CINAHL Plus from inception to July 2021.
Sixty-one studies with a total of 2728 participants (1454 patients with AD, 163 patients with MCI, and 1111 CN) were included. Patients with AD showed significantly higher cortical excitability, lower cortical inhibition, and impaired cortical plasticity compared to the CN cohorts. Patients with MCI exhibited increased cortical excitability and reduced plasticity compared to the CN cohort. Additionally, lower cognitive performance was significantly associated with higher cortical excitability and lower inhibition. No seizure events due to TMS were reported, and the mild adverse response rate is approximately 3/1000 (i.e., 9/2728).
Findings of our meta-analysis demonstrate the potential of using TMS-derived cortical excitability and plasticity measures as diagnostic biomarkers and therapeutic targets for AD and MCI.
经颅磁刺激（TMS）是一种非侵入性的神经调节技术。当刺激施加于初级运动皮层并与肌电图测量相结合时，TMS 可以探测皮质兴奋性和体内可塑性的功能。本荟萃分析的目的是评估 TMS 衍生测量值在区分阿尔茨海默病（AD）和轻度认知障碍（MCI）患者与认知正常老年人（CN）中的效用。
从开始到 2021 年 7 月，我们搜索了 PubMed、Embase、APA PsycInfo、Medline 和 CINAHL Plus 等数据库。
共有 61 项研究，共计 2728 名参与者（1454 名 AD 患者、163 名 MCI 患者和 1111 名 CN）纳入本研究。与 CN 队列相比，AD 患者的皮质兴奋性更高，皮质抑制更低，皮质可塑性受损。与 CN 队列相比，MCI 患者的皮质兴奋性增加，可塑性降低。此外，较低的认知表现与较高的皮质兴奋性和较低的抑制显著相关。没有因 TMS 而导致的癫痫发作事件报告，轻度不良反应发生率约为 3/1000（即 9/2728）。
我们的荟萃分析结果表明，TMS 衍生的皮质兴奋性和可塑性测量值有作为 AD 和 MCI 的诊断生物标志物和治疗靶点的潜力。
