Effects of a periodic intermittent theta burst stimulation in Alzheimer’s disease

磁刺激 蒙特利尔认知评估 心理学 海马体 痴呆 认知功能衰退 临床痴呆评级 神经科学 萎缩 睡眠剥夺对认知功能的影响 背外侧前额叶皮质 刺激 医学 内科学 认知 前额叶皮质 疾病 认知障碍
作者
Xingqi Wu,Yibing Yan,Panpan Hu,Lu Wang,Yue Wu,Pan Wu,Zhi Geng,Guixian Xiao,Shanshan Zhou,Gong‐Jun Ji,Bensheng Qiu,Ling Wei,Yanghua Tian,Hesheng Liu,Kang Wang
出处
期刊:General psychiatry [BMJ]
卷期号:37 (1): e101106-e101106 被引量:1
标识
DOI:10.1136/gpsych-2023-101106
摘要

Background Previous studies have demonstrated that excitatory repetitive transcranial magnetic stimulation (rTMS) can improve the cognitive function of patients with Alzheimer’s disease (AD). Intermittent theta burst stimulation (iTBS) is a novel excitatory rTMS protocol for brain activity stimulation with the ability to induce long-term potentiation-like plasticity and represents a promising treatment for AD. However, the long-term effects of iTBS on cognitive decline and brain structure in patients with AD are unknown. Aims We aimed to explore whether repeating accelerated iTBS every three months could slow down the cognitive decline in patients with AD. Methods In this randomised, assessor-blinded, controlled trial, iTBS was administered to the left dorsolateral prefrontal cortex (DLPFC) of 42 patients with AD for 14 days every 13 weeks. Measurements included the Montreal Cognitive Assessment (MoCA), a comprehensive neuropsychological battery, and the grey matter volume (GMV) of the hippocampus. Patients were evaluated at baseline and after follow-up. The longitudinal pipeline of the Computational Anatomy Toolbox for SPM was used to detect significant treatment-related changes over time. Results The iTBS group maintained MoCA scores relative to the control group (t=3.26, p=0.013) and reduced hippocampal atrophy, which was significantly correlated with global degeneration scale changes. The baseline Mini-Mental State Examination (MMSE) score, apolipoprotein E genotype and Clinical Dementia Rating were indicative of MoCA scores at follow-up. Moreover, the GMV of the left (t=0.08, p=0.996) and right (t=0.19, p=0.977) hippocampus were maintained in the active group but significantly declined in the control group (left: t=4.13, p<0.001; right: t=5.31, p < 0.001). GMV change in the left (r=0.35, p=0.023) and right (r=0.36, p=0.021) hippocampus across the intervention positively correlated with MoCA changes; left hippocampal GMV change was negatively correlated with global degeneration scale (r=−0.32, p=0.041) changes. Conclusions DLPFC-iTBS may be a feasible and easy-to-implement non-pharmacological intervention to slow down the progressive decline of overall cognition and quality of life in patients with AD, providing a new AD treatment option. Trial registration number NCT04754152 .
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