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De Paolis ML, Paoletti I, Zaccone C, Capone F, D'Amelio M, Krashia P. Transcranial alternating current stimulation (tACS) at gamma frequency: an up-and-coming tool to modify the progression of Alzheimer's Disease. Transl Neurodegener 2024; 13:33. [PMID: 38926897 PMCID: PMC11210106 DOI: 10.1186/s40035-024-00423-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024] Open
Abstract
The last decades have witnessed huge efforts devoted to deciphering the pathological mechanisms underlying Alzheimer's Disease (AD) and to testing new drugs, with the recent FDA approval of two anti-amyloid monoclonal antibodies for AD treatment. Beyond these drug-based experimentations, a number of pre-clinical and clinical trials are exploring the benefits of alternative treatments, such as non-invasive stimulation techniques on AD neuropathology and symptoms. Among the different non-invasive brain stimulation approaches, transcranial alternating current stimulation (tACS) is gaining particular attention due to its ability to externally control gamma oscillations. Here, we outline the current knowledge concerning the clinical efficacy, safety, ease-of-use and cost-effectiveness of tACS on early and advanced AD, applied specifically at 40 Hz frequency, and also summarise pre-clinical results on validated models of AD and ongoing patient-centred trials.
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Affiliation(s)
- Maria Luisa De Paolis
- Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21 - 00128, Rome, Italy
| | - Ilaria Paoletti
- Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21 - 00128, Rome, Italy
| | - Claudio Zaccone
- Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21 - 00128, Rome, Italy
| | - Fioravante Capone
- Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21 - 00128, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128, Rome, Italy
| | - Marcello D'Amelio
- Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21 - 00128, Rome, Italy.
- Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, Via del Fosso Di Fiorano, 64 - 00143, Rome, Italy.
| | - Paraskevi Krashia
- Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, Via del Fosso Di Fiorano, 64 - 00143, Rome, Italy
- Department of Sciences and Technologies for Sustainable Development and One Health, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21 - 00128, Rome, Italy
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Pan S, Hu Y, Zhang H, He Y, Tian C, Lei J. The Current Status and Trends of Research Related to Vestibular Disorders, Vertigo, and Cognitive Impairment in the Elderly Population: A Bibliometric Analysis. EAR, NOSE & THROAT JOURNAL 2024:1455613241257396. [PMID: 38818829 DOI: 10.1177/01455613241257396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
Background: The vestibular system not only supports reflex function at the brainstem level, but is also associated with higher levels of cognitive function. Vertigo due to vestibular disorders may lead to or be associated with cognitive dysfunction. Patients with deficits of both vestibular as well as cognitive function may be at particularly high risk for events like falls or certain diseases, such as Alzheimer's. Objective: To analyze the current state of research and trends in the global research literature regarding the correlation between vestibular disorders, vertigo, and cognitive impairment. Methods: We utilized Bibliometrix package to search databases including PubMed, Web of Science, etc for search terms. Results: Databases were searched up to December 15, 2022, and a total of 2222 publications were retrieved. Ultimately, 53 studies were included. A total of 261 authors published in 38 journals and conferences with an overall increasing annual growth rate of 6.94%. The most-published journal was Frontiers in Neurology. The most-published country was the United States, followed by Italy and Brazil. The most-published institution was Johns Hopkins University with a total of 13 articles. On performing trend analysis, we found that the most frequent focus of research in this field include the testing of vestibular perception, activation of the brain-related cortex, and the influence of stimulus-triggered vestibular snail reflex on visual space. The potential focal points are the risk of falling and the ability to extract spatial memory information, and the focus of research in recent decades has revolved around balance, falling, and Alzheimer's disease. Conclusions: Vestibular impairment in older adults affects cognitive function, particularly immediate memory, visuospatial cognition, and attention, with spatial cognition being the most significantly affected. In the future, virtual reality-based vestibular rehabilitation techniques and caloric stimulation could be potential interventions for the treatment of cognitive impairment.
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Affiliation(s)
- Sijia Pan
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanjia Hu
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Huiying Zhang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yunfan He
- School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chenghua Tian
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jianbo Lei
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, China
- School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, Sichuan, China
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Manippa V, Palmisano A, Nitsche MA, Filardi M, Vilella D, Logroscino G, Rivolta D. Cognitive and Neuropathophysiological Outcomes of Gamma-tACS in Dementia: A Systematic Review. Neuropsychol Rev 2024; 34:338-361. [PMID: 36877327 PMCID: PMC10920470 DOI: 10.1007/s11065-023-09589-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 01/23/2023] [Indexed: 03/07/2023]
Abstract
Despite the numerous pharmacological interventions targeting dementia, no disease-modifying therapy is available, and the prognosis remains unfavorable. A promising perspective involves tackling high-frequency gamma-band (> 30 Hz) oscillations involved in hippocampal-mediated memory processes, which are impaired from the early stages of typical Alzheimer's Disease (AD). Particularly, the positive effects of gamma-band entrainment on mouse models of AD have prompted researchers to translate such findings into humans using transcranial alternating current stimulation (tACS), a methodology that allows the entrainment of endogenous cortical oscillations in a frequency-specific manner. This systematic review examines the state-of-the-art on the use of gamma-tACS in Mild Cognitive Impairment (MCI) and dementia patients to shed light on its feasibility, therapeutic impact, and clinical effectiveness. A systematic search from two databases yielded 499 records resulting in 10 included studies and a total of 273 patients. The results were arranged in single-session and multi-session protocols. Most of the studies demonstrated cognitive improvement following gamma-tACS, and some studies showed promising effects of gamma-tACS on neuropathological markers, suggesting the feasibility of gamma-tACS in these patients anyhow far from the strong evidence available for mouse models. Nonetheless, the small number of studies and their wide variability in terms of aims, parameters, and measures, make it difficult to draw firm conclusions. We discuss results and methodological limitations of the studies, proposing possible solutions and future avenues to improve research on the effects of gamma-tACS on dementia.
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Affiliation(s)
- Valerio Manippa
- Department of Education, Psychology and Communication, University of Bari "Aldo Moro", Bari, Italy.
| | - Annalisa Palmisano
- Department of Education, Psychology and Communication, University of Bari "Aldo Moro", Bari, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Marco Filardi
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro" at Pia Fondazione "Cardinale G. Panico", Tricase, Lecce, Italy
- Department of Basic Medicine, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Davide Vilella
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro" at Pia Fondazione "Cardinale G. Panico", Tricase, Lecce, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro" at Pia Fondazione "Cardinale G. Panico", Tricase, Lecce, Italy
- Department of Basic Medicine, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Davide Rivolta
- Department of Education, Psychology and Communication, University of Bari "Aldo Moro", Bari, Italy
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Kruse CS, Sen K, Armenta V, Hubbard N, Brooks R. Leveraging mHealth and Virtual Reality to Improve Cognition for Alzheimer’s Patients: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10101845. [PMID: 36292292 PMCID: PMC9602027 DOI: 10.3390/healthcare10101845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 12/01/2022] Open
Abstract
Background: Alzheimer’s Disease (AD) is a global problem affecting 58 million people, expected to reach a prevalence of 88 million people by 2050. The disease affects the brain, memory, cognition, language, and motor movement. Many interventions have sought to improve memory and cognition. mHealth and virtual reality (VR) are two such interventions. Objectives: To analyze studies from the last 10 years with older adults with AD to ascertain the effectiveness of telehealth techniques such as mHealth and VR for memory care. Methods: In accordance with the Kruse Protocol and reported in accordance with PRISMA 2020, five reviewers searched four research databases (PubMed, CINAHL, Web of Science, and ScienceDirect) on 3 August 2022 for studies with strong methodologies that fit the objective statement. Results: Twenty-two studies from 13 countries were analyzed for trends. Four interventions (mHealth/eHealth, VR, mHealth + VR, game console, and telephone) used RCT, quasi-experimental, pre-post, observational, and mixed methods. These interventions improved cognition, memory, brain activity, language, depression, attention, vitality, quality of life, cortical atrophy, cerebral blood flow, neuro plasticity, and mental health. Only three interventions reported either no improvements or no statistically significant improvements. Cost, time, training, and low reimbursement were barriers to the adoption of these interventions. Conclusion: mHealth and VR offer interventions with positive effectiveness for memory care for AD. The long-term effect of this improvement is unclear. Additional research is needed in this area to establish clinical practice guidelines.
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