Transcranial magnetic stimulation of the precuneus enhances memory and neural activity in prodromal Alzheimer's disease

Giacomo Koch, Sonia Bonnì, Maria Concetta Pellicciari, Elias P. Casula, Matteo Mancini, Romina Esposito, Viviana Ponzo, Silvia Picazio, Francesco Di Lorenzo, Laura Serra, Caterina Motta, Michele Maiella (+5 others)
2018 NeuroImage  
1 Memory loss is one of the first symptoms of typical Alzheimer's disease (AD), for which there are 2 no effective therapies available. The precuneus (PC) has been recently emphasized as a key area for 3 the memory impairment observed in early AD, likely due to disconnection mechanisms within 4 large-scale networks. Using a multimodal approach we investigated in a two-week, randomized, 5 sham-controlled, double-blinded trial the effects of high-frequency repetitive transcranial magnetic 6
more » ... ation (rTMS) of the PC on cognition, as measured by the Alzheimer Disease Cooperative 7 Study Preclinical Alzheimer Cognitive Composite in 14 patients with early AD (7 females). TMS 8 combined with electroencephalography (TMS-EEG) was used to detect changes in brain 9 connectivity. We found that rTMS of the PC induced a selective improvement in episodic memory, 10 but not in other cognitive domains. Analysis of TMS-EEG signal revealed an increase of neural 11 activity in patients' PC, an enhancement of brain oscillations in the beta band and a modification of 12 functional connections between the PC and medial frontal areas. 13 Our findings show that high-frequency rTMS of the PC is a promising, non-invasive treatment for 14 memory dysfunction in patients at early stages of AD. This clinical improvement is accompanied by 15 modulation of brain connectivity, consistently with the pathophysiological model of brain 16 disconnection in AD. 17 18
doi:10.1016/j.neuroimage.2017.12.048 pmid:29277405 fatcat:hgojiwalzncr3i7pn73p6mrv34