Central European Institute of Technology, CEITEC, Masaryk University, Applied Neuroscience Research Group, Brno, Czech Republic; 1(st) Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Clin Neurophysiol. 2022 Dec;144:23-40. doi: 10.1016/j.clinph.2022.09.010. Epub 2022 Sep 28.
Alzheimer's disease dementia (AD) and its preclinical stage, mild cognitive impairment (MCI), are critical issues confronting the aging society. Non-invasive brain stimulation (NIBS) techniques have the potential to be effective tools for enhancing cognitive functioning. The main objective of our meta-analysis was to quantify and update the status of the efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) and Transcranial Direct Current Stimulation (tDCS) when applied in AD and MCI.
The systematic literature search was conducted in PubMed and Web of Science according to PRISMA statement.
Pooled effect sizes (Hedges' g) from 32 studies were analyzed using random effect models. We found both, rTMS and tDCS to have significant immediate cognition-enhancing effect in AD with rTMS inducing also beneficial long-term effects. We found no evidence for synergistic effect of cognitive training with NIBS.
In AD a clinical recommendation can be made for NEURO-AD system and for high-frequency rTMS over the left dorsolateral prefrontal cortex (DLPFC) as probably effective protocols (B-level of evidence) and for anodal tDCS over the left DLPFC as a possibly effective.
According to scientific literature, NIBS may be an effective method for improving cognition in AD and possibly in MCI.
阿尔茨海默病性痴呆（AD）及其临床前阶段，轻度认知障碍（MCI），是老龄化社会面临的关键问题。非侵入性脑刺激（NIBS）技术有可能成为增强认知功能的有效工具。我们的荟萃分析的主要目的是量化和更新重复经颅磁刺激（rTMS）和经颅直流电刺激（tDCS）在 AD 和 MCI 中的疗效状况。
根据 PRISMA 声明，在 PubMed 和 Web of Science 中进行了系统文献检索。
使用随机效应模型分析了 32 项研究的汇总效应大小（Hedges'g）。我们发现 rTMS 和 tDCS 都对 AD 具有显著的即时认知增强作用，rTMS 还具有有益的长期作用。我们没有发现认知训练与 NIBS 协同作用的证据。
在 AD 中，可以推荐使用 NEURO-AD 系统和高频 rTMS 对左侧背外侧前额叶皮层（DLPFC）进行治疗，作为可能有效的方案（B 级证据），以及使用左侧 DLPFC 的阳极 tDCS 作为可能有效的方案。
根据科学文献，NIBS 可能是改善 AD 认知功能的有效方法，可能对 MCI 也有效。
