Effects of a periodic intermittent theta burst stimulation in Alzheimer’s disease
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 stimulati...
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BMJ Publishing Group
2024-02-01
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| Series: | General Psychiatry |
| Online Access: | https://gpsych.bmj.com/content/37/1/e101106.full |
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| author | Yue Wu Lu Wang Kai Wang Shanshan Zhou Pan Wu Yibing Yan Ling Wei Bensheng Qiu Yanghua Tian Zhi Geng Xingqi Wu Panpan Hu Guixian Xiao Gongjun Ji Hesheng Liu |
| author_facet | Yue Wu Lu Wang Kai Wang Shanshan Zhou Pan Wu Yibing Yan Ling Wei Bensheng Qiu Yanghua Tian Zhi Geng Xingqi Wu Panpan Hu Guixian Xiao Gongjun Ji Hesheng Liu |
| author_sort | Yue Wu |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-88b7b439a5fa43e29968956d3f13612e |
| institution | Kabale University |
| issn | 2517-729X |
| language | English |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
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| series | General Psychiatry |
| spelling | doaj-art-88b7b439a5fa43e29968956d3f13612e2025-01-29T15:45:09ZengBMJ Publishing GroupGeneral Psychiatry2517-729X2024-02-0137110.1136/gpsych-2023-101106Effects of a periodic intermittent theta burst stimulation in Alzheimer’s diseaseYue Wu0Lu Wang1Kai Wang2Shanshan Zhou3Pan Wu4Yibing Yan5Ling Wei6Bensheng Qiu7Yanghua Tian8Zhi Geng9Xingqi Wu10Panpan Hu11Guixian Xiao12Gongjun Ji13Hesheng Liu14Elpiscience Biopharma, Ltd., Shanghai, China4 Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui, China1 Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China1 Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China1 Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China1 Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China1 Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China6 Center for Biomedical Imaging, University of Science and Technology of China, Hefei, Anhui, China7 Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, Anhui, China1 Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China1 Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China1 Jiangsu Key Laboratory of Neurodegeneration, Nanjing Medical University, Nanjing, Jiangsu, China1 Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China1 Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China2 Division of Brain Sciences, Changping Laboratory, Beijing, ChinaBackground 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.https://gpsych.bmj.com/content/37/1/e101106.full |
| spellingShingle | Yue Wu Lu Wang Kai Wang Shanshan Zhou Pan Wu Yibing Yan Ling Wei Bensheng Qiu Yanghua Tian Zhi Geng Xingqi Wu Panpan Hu Guixian Xiao Gongjun Ji Hesheng Liu Effects of a periodic intermittent theta burst stimulation in Alzheimer’s disease General Psychiatry |
| title | Effects of a periodic intermittent theta burst stimulation in Alzheimer’s disease |
| title_full | Effects of a periodic intermittent theta burst stimulation in Alzheimer’s disease |
| title_fullStr | Effects of a periodic intermittent theta burst stimulation in Alzheimer’s disease |
| title_full_unstemmed | Effects of a periodic intermittent theta burst stimulation in Alzheimer’s disease |
| title_short | Effects of a periodic intermittent theta burst stimulation in Alzheimer’s disease |
| title_sort | effects of a periodic intermittent theta burst stimulation in alzheimer s disease |
| url | https://gpsych.bmj.com/content/37/1/e101106.full |
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