Repetitive transcranial magnetic stimulation combined with cognitive training is a safe and effective modality for the treatment of Alzheimer’s disease: a randomized, double-blind study

Abstract

Cortical excitability can be modulated using repetitive transcranial magnetic stimulation (rTMS). Previously, we showed that rTMS combined with cognitive training (rTMS-COG) has positive results in Alzheimer's disease (AD). The goal of this randomized double-blind, controlled study was to examine the safety and efficacy of rTMS-COG in AD. Fifteen AD patients received 1-h daily rTMS-COG or sham treatment (seven treated, eight placebo), five sessions/week for 6 weeks, followed by biweekly sessions for 3 months. The primary outcome was improvement of the cognitive score. The secondary outcome included improvement in the Clinical Global Impression of Change (CGIC) and Neuropsychiatric Inventory (NPI). There was an improvement in the average ADAS-cog score of 3.76 points after 6 weeks in the treatment group compared to 0.47 in the placebo group and 3.52 points after 4.5 months of treatment, compared to worsening of 0.38 in the placebo (P = 0.04 and P = 0.05, respectively). There was also an improvement in the average CGIC score of 3.57 (after 6 weeks) and 3.67 points (after 4.5 months), compared to 4.25 and 4.29 in the placebo group (mild worsening) (P = 0.05 and P = 0.05, respectively). NPI improved non-significantly. In summary, the NeuroAD system offers a novel, safe and effective therapy for improving cognitive function in AD.

Cognitive Therapy for Dementia Patients: A Systematic Review

“…Most studies included elderly with mild cognitive impairments [35, 36, 41-43, 47, 49-51, 53, 55, 56], some studies included elderly at risk for dementia [38,52,58], some other studies patients with mild to moderate dementia [37,46,57], moderate to severe dementia [34,48], diagnosed with Alzheimer disease [39,40,44,45,48,51,54].…”

Non-Invasive Brain Stimulation in Dementia: A Complex Network Story

“…Moreover, the majority of the studies have focused on memory, the core clinical symptom. Ten studies were designed as multiple session paradigm [81, 83, 84, 86-88, 90, 92-94], and a cognitive training was combined with the stimulation protocol in 3 of the brain stimulation studies on AD [84, 93, 94]. …”

Similar clinical improvement and maintenance after rTMS at 5 Hz using a simple vs. complex protocol in Alzheimer’s disease

“…High frequency (HF) rTMS applied on the right or left DLPFC has shown improvement in language abilities, in cognitive function, functionality and behavior for up to 3 months (5). Other studies have shown similar results on cognition, behavior and function using HF applied over several cortical sites in a complex design (6). This complex design may include at least 6 cortical targets, and it is suggested to be more beneficial than DLPFC (7,8).…”