Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China.
Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, 321 Zhongshan Road, Nanjing, 210008, China.
Cereb Cortex. 2024 Nov 5;34(11). doi: 10.1093/cercor/bhae460.
Intermittent theta burst stimulation, a derivative of repetitive transcranial magnetic stimulation, has been applied to improve cognitive deficits. However, its efficacy and mechanisms in enhancing cognitive function in patients with amnestic mild cognitive impairment compared with traditional repetitive transcranial magnetic stimulation paradigms remain unclear. This study recruited 48 amnestic mild cognitive impairment patients, assigning them to intermittent theta burst stimulation, repetitive transcranial magnetic stimulation, and sham groups (5 times/wk for 4 wk). Neuropsychological assessments and functional magnetic resonance imaging data were collected pre- and post-treatment. Regarding efficacy, both angular gyrus intermittent theta burst stimulation and repetitive transcranial magnetic stimulation significantly improved general cognitive function and memory compared to the sham group, with no significant difference between the 2 treatment groups. Mechanistically, significant changes in brain activity within the temporoparietal network were observed in both the intermittent theta burst stimulation and repetitive transcranial magnetic stimulation groups, and these changes correlated with improvements in general cognitive and memory functions. Additionally, intermittent theta burst stimulation showed stronger modulation of functional connectivity between the hippocampus, parahippocampal gyrus, and temporal regions compared to repetitive transcranial magnetic stimulation. The intermittent theta burst stimulation and repetitive transcranial magnetic stimulation can improve cognitive function in amnestic mild cognitive impairment patients, but intermittent theta burst stimulation may offer higher efficiency. Intermittent theta burst stimulation and repetitive transcranial magnetic stimulation likely enhance cognitive function, especially memory function, by modulating the temporoparietal network.
经颅磁刺激的一种衍生技术——间歇性 theta 爆发刺激，已被应用于改善认知障碍。然而，与传统的经颅磁刺激模式相比，其在改善遗忘型轻度认知障碍患者认知功能方面的疗效和机制尚不清楚。本研究招募了 48 名遗忘型轻度认知障碍患者，将他们分为间歇性 theta 爆发刺激组、经颅磁刺激组和假刺激组（每周 5 次，共 4 周）。在治疗前后收集了神经心理学评估和功能磁共振成像数据。关于疗效，与假刺激组相比，角回间歇性 theta 爆发刺激和经颅磁刺激均显著改善了一般认知功能和记忆，两组治疗之间无显著差异。在机制上，间歇性 theta 爆发刺激和经颅磁刺激组均观察到颞顶网络内的脑活动发生了显著变化，这些变化与一般认知和记忆功能的改善相关。此外，与经颅磁刺激相比，间歇性 theta 爆发刺激显示出更强的调节海马、海马旁回和颞叶区域之间功能连接的能力。间歇性 theta 爆发刺激和经颅磁刺激均可改善遗忘型轻度认知障碍患者的认知功能，但间歇性 theta 爆发刺激可能具有更高的效率。间歇性 theta 爆发刺激和经颅磁刺激可能通过调节颞顶网络来增强认知功能，特别是记忆功能。
