A case report of daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) as an adjunctive treatment for Alzheimer disease

Emmanuel Haffen, Gilles Chopard, Jean-Baptiste Pretalli, Eloi Magnin, Magali Nicolier, Julie Monnin, Jean Galmiche, Lucien Rumbach, Lionel Pazart, Daniel Sechter, Pierre Vandel
2012 Brain Stimulation  
Alzheimer's disease (AD) is the most common type of dementia. Current medication treatment is based on two main groups: anticholinesterases (IAChE) and NMDA receptor antagonists. These medications have demonstrated a symptomatic effect on certain cognitive and noncognitive symptoms of AD in the short term (6 months in most studies), although these effects are only limited. 1,2 With diagnostic tools for AD becoming increasingly sophisticated, the pathology is identified at earlier stages than
more » ... ore, 3 so suitable therapies must follow to limit the progression of the illness and the cognitive loss associated with it. We report the use of a noninvasive procedure, repetitive transcranial magnetic stimulation (rTMS), on cognitive symptoms of an AD patient. Materials and methods Case study The patient was a 75-year-old right-handed man with a high educational level, selected from the Memory Center of Research and Resources of Besançon. He was diagnosed 2 years ago with probable AD according to NINCDS-ADRDA criteria 4 and treated with memantine (20 mg/d up to 36 months), donepezil (10 mg/d up to 36 months), and venlafaxine (75 mg/d up to 12 months) because of the emergence of depressive symptoms in reaction to the diagnosis and resolved last year. His wife had noticed progressive difficulty in remembering recent events and spatiotemporal disorientation for about 2 years associated with word finding problems and poor decision-making capacity that interfere with daily living activities. A T2-weighted magnetic resonance image (MRI) demonstrated mild hippocampal atrophy and marked biparietal atrophy with no vascular leukoencephalopathy (Figure supplementary material) . The ethics committee of Besançon University Hospital gave its official approval to conduct the protocol and the Correspondence: Prof. Emmanuel Haffen,
doi:10.1016/j.brs.2011.03.003 pmid:22037125 fatcat:3oxprddribfopmpk4llt5jgh3y