Sacco Leonardo, Ceroni Martino, Pacifico Deborah, Zerboni Giorgia, Rossi Stefania, Galati Salvatore, Caverzasio Serena, Kaelin-Lang Alain, Riccitelli Gianna C
Neuropsychology and Behavioral Neurology Research Unit, Neurocenter of Southern Switzerland, EOC, 6900 Lugano, Switzerland.
Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland.
Diagnostics (Basel). 2023 Jan 23;13(3):415. doi: 10.3390/diagnostics13030415.
(1) Background: Patients with mild cognitive impairment (MCI) often present impairment in executive functions (EFs). This study aimed to investigate the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on EFs in patients with MCI. (2) Methods: A prospective trial was conducted on 11 patients with MCI. Participants underwent 25 min of 20 Hz rTMS for ten days on the right temporo-parietal junction (RTPJ) and medial prefrontal cortex (MPFC). Before (T0) and after rTMS treatment (T1), global cognitive profile and EFs were investigated using the Montreal cognitive assessment (MoCA), trial making test (TMT) A and B, and frontal assessment battery (FAB). Depression symptoms were assessed using the geriatric depression scale (GDS). Statistical analysis included Wilcoxon signed-rank test. (3) Results: After treatment, patients showed a significant improvement in the MoCA EFs subtask (T0 vs. T1, = 0.015) and TMT-B (T0 vs. T1, = 0.028). Five MCI patients with EF impairment showed full recovery of these deficits. No significant changes in the GDS were observed. (4) Conclusions: rTMS stimulation over the TPJ and MPFC induced significant short-term improvements in EFs in MCI patients. These findings suggest that the TPJ and MPFC may be involved in the attention-executive skills to redirect attention toward behaviorally relevant stimuli.
(1) 背景：轻度认知障碍（MCI）患者常存在执行功能（EFs）受损。本研究旨在探讨高频重复经颅磁刺激（rTMS）对MCI患者执行功能的影响。(2) 方法：对11例MCI患者进行前瞻性试验。参与者在右侧颞顶联合区（RTPJ）和内侧前额叶皮质（MPFC）接受为期10天、每天25分钟、频率为20Hz的rTMS治疗。在rTMS治疗前（T0）和治疗后（T1），使用蒙特利尔认知评估量表（MoCA）、连线测验（TMT）A和B以及额叶评估量表（FAB）对整体认知概况和执行功能进行评估。使用老年抑郁量表（GDS）评估抑郁症状。统计分析采用Wilcoxon符号秩检验。(3) 结果：治疗后，患者在MoCA执行功能子任务（T0与T1比较，P = 0.015）和TMT - B（T0与T1比较，P = 0.028）方面有显著改善。5例存在执行功能障碍的MCI患者这些缺陷完全恢复。未观察到GDS有显著变化。(4) 结论：对颞顶联合区和内侧前额叶皮质进行rTMS刺激可使MCI患者的执行功能在短期内得到显著改善。这些发现表明，颞顶联合区和内侧前额叶皮质可能参与了将注意力重新导向行为相关刺激的注意力 - 执行技能。
