Papallo Simone, Di Nardo Federica, Siciliano Mattia, Esposito Sabrina, Canale Fabrizio, Cirillo Giovanni, Cirillo Mario, Trojsi Francesca, Esposito Fabrizio
Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
First Division of Neurology and Neurophysiopathology, University Hospital, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
J Clin Med. 2024 Sep 10;13(18):5367. doi: 10.3390/jcm13185367.
: Repetitive transcranial magnetic stimulation (rTMS) has shown therapeutic effects in neurological patients by inducing neural plasticity. In this pilot study, we analyzed the modifying effects of high-frequency (HF-)rTMS applied to the dorsolateral prefrontal cortex (DLPFC) of patients with mild cognitive impairment (MCI) using an advanced approach of functional connectome analysis based on network control theory (NCT). : Using local-to-global functional parcellation, average and modal controllability (AC/MC) were estimated for DLPFC nodes of prefrontal-lateral control networks (R/LH_Cont_PFCl_3/4) from a resting-state fMRI series acquired at three time points (T0 = baseline, T1 = T0 + 4 weeks, T2 = T1 + 20 weeks) in MCI patients receiving regular daily sessions of 10 Hz HF-rTMS ( = 10, 68.00 ± 8.16 y, 4 males) or sham ( = 10, 63.80 ± 9.95 y, 5 males) stimulation, between T0 and T1. Longitudinal (group) effects on AC/MC were assessed with non-parametric statistics. Spearman correlations (ρ) of AC/MC vs. neuropsychological (RBANS) score %change (at T1, T2 vs. T0) were calculated. AC median was reduced in MCI-rTMS, compared to the control group, for RH_Cont_PFCl_3/4 at T1 and T2 (vs. T0). In MCI-rTMS patients, for RH_Cont_PFCl_3, AC % change at T1 (vs. T0) was negatively correlated with semantic fluency (ρ = -0.7939, = 0.045) and MC % change at T2 (vs. T0) was positively correlated with story memory (ρ = 0.7416, = 0.045). : HF-rTMS stimulation of DLFC nodes significantly affects the controllability of the functional connectome in MCI patients. Emerging correlations between AC/MC controllability and cognitive performance changes, immediately (T1 vs. T0) and six months (T2 vs. T0) after treatment, suggest NCT could help explain the HF-rTMS impact on prefrontal-lateral control network, monitoring induced neural plasticity effects in MCI patients.
重复经颅磁刺激（rTMS）已通过诱导神经可塑性在神经疾病患者中显示出治疗效果。在这项初步研究中，我们使用基于网络控制理论（NCT）的功能连接组分析的先进方法，分析了高频（HF-）rTMS应用于轻度认知障碍（MCI）患者背外侧前额叶皮质（DLPFC）的调节作用。 使用局部到全局的功能分区，从在三个时间点（T0 =基线，T1 = T0 + 4周，T2 = T1 + 20周）采集的静息态功能磁共振成像（fMRI）系列中，估计接受每日10 Hz HF-rTMS常规治疗（n = 10，68.00±8.16岁，4名男性）或假刺激（n = 10，63.80±9.95岁，5名男性）的MCI患者前额叶外侧控制网络（R/LH_Cont_PFCl_3/4）的DLPFC节点的平均和模态可控性（AC/MC）。在T0和T1之间，使用非参数统计评估对AC/MC的纵向（组）效应。计算AC/MC与神经心理学（RBANS）评分变化百分比（在T1、T2与T0时）的斯皮尔曼相关性（ρ）。 与对照组相比，MCI-rTMS组在T1和T2（与T0相比）时，RH_Cont_PFCl_3/4的AC中位数降低。在MCI-rTMS患者中，对于RH_Cont_PFCl_3，T1（与T0相比）时的AC变化百分比与语义流畅性呈负相关（ρ = -0.7939，p = 0.045），T2（与T0相比）时的MC变化百分比与故事记忆呈正相关（ρ = 0.7416，p = 0.045）。 HF-rTMS刺激DLFC节点显著影响MCI患者功能连接组的可控性。治疗后即刻（T1与T0相比）和六个月（T2与T0相比），AC/MC可控性与认知表现变化之间新出现的相关性表明，NCT有助于解释HF-rTMS对前额叶外侧控制网络的影响，监测MCI患者中诱导的神经可塑性效应。
