Repetitive Transcranial Magnetic Stimulation in the Treatment of Alzheimer’s Disease and Other Dementias

Abstract

Dementia is a debilitating impairment of cognitive functions that affects millions of people worldwide. There are several diseases belonging to the dementia spectrum, most prominently Alzheimer’s disease (AD), vascular dementia (VD), Lewy body dementia (LBD) and frontotemporal dementia (FTD). Repetitive transcranial magnetic stimulation (rTMS) is a safe, non-invasive form of brain stimulation that utilizes a magnetic coil to generate an electrical field and induce numerous changes in the brain. It is considered efficacious for the treatment of various neuropsychiatric disorders. In this paper, we review the available studies involving rTMS in the treatment of these dementia types. The majority of studies have involved AD and shown beneficial effects, either as a standalone, or as an add-on to standard-of-care pharmacological treatment and cognitive training. The dorsolateral prefrontal cortex seems to hold a central position in the applied protocols, but several parameters still need to be defined. In addition, rTMS has shown potential in mild cognitive impairment as well. Regarding the remaining dementias, research is still at preliminary phases, and large, randomized studies are currently lacking.

Therapeutic Application of rTMS in Atypical Parkinsonian Disorders

“…The application of rTMS in earlier disease stages is another issue that needs to be discussed. For instance, regarding AD, a common degenerative disorder combined with dementia, the excitant literature shows that patients in earlier stages had responded better after treatment with rTMS [ 32 , 62 , 63 ]. This phenomenon could be explained from the smaller degree of brain atrophy, contributing to better responsiveness to rTMS [ 64 ].…”

“…rTMS has been considered to be a therapeutic option for many pathologies, such as depression, migraine, and epilepsy [ 29 – 31 ], and even neurodegenerative conditions with cognitive sequelae, such as Alzheimer's disease [ 32 ]. In addition, rTMS has been extensively studied in PD, showing positive effects in motor and nonmotor symptoms and in therapy complications [ 33 ].…”