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For: Pievani M, Mega A, Quattrini G, Guidali G, Ferrari C, Cattaneo A, D'Aprile I, Mascaro L, Gasparotti R, Corbo D, Brignani D, Bortoletto M. Targeting Default Mode Network Dysfunction in Persons at Risk of Alzheimer's Disease with Transcranial Magnetic Stimulation (NEST4AD): Rationale and Study Design. J Alzheimers Dis 2021;83:1877-1889. [PMID: 34459405 DOI: 10.3233/jad-210659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]

For:	Pievani M, Mega A, Quattrini G, Guidali G, Ferrari C, Cattaneo A, D'Aprile I, Mascaro L, Gasparotti R, Corbo D, Brignani D, Bortoletto M. Targeting Default Mode Network Dysfunction in Persons at Risk of Alzheimer's Disease with Transcranial Magnetic Stimulation (NEST4AD): Rationale and Study Design. J Alzheimers Dis 2021;83:1877-1889. [PMID: 34459405 DOI: 10.3233/jad-210659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]

Number

Cited by Other Article(s)

Wang T, Yan S, Lu J. The effects of noninvasive brain stimulation on cognitive function in patients with mild cognitive impairment and Alzheimer's disease using resting-state functional magnetic resonance imaging: A systematic review and meta-analysis. CNS Neurosci Ther 2023;29:3160-3172. [PMID: 37349974 PMCID: PMC10580344 DOI: 10.1111/cns.14314] [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: 03/03/2023] [Revised: 05/08/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023] Open

Sharbafshaaer M, Gigi I, Lavorgna L, Esposito S, Bonavita S, Tedeschi G, Esposito F, Trojsi F. Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions-A Systematic Review. J Clin Med 2023;12:6190. [PMID: 37834834 PMCID: PMC10573645 DOI: 10.3390/jcm12196190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique also used as a non-pharmacological intervention against cognitive impairment. The purpose of the present review was to summarize what is currently known about the effectiveness of rTMS intervention on different cognitive domains in patients with mild cognitive impairment (MCI) and to address potential neuromodulation approaches in combination with electroencephalography (EEG) and neuroimaging, especially functional magnetic resonance imaging (fMRI). In this systematic review, we consulted three main databases (PubMed, Science Direct, and Scopus), and Google Scholar was selected for the gray literature search. The PRISMA flowchart drove the studies' inclusion. The selection process ensured that only high-quality studies were included; after removing duplicate papers, explicit ratings were given based on the quality classification as high (A), moderate (B), or low (C), considering factors such as risks of bias, inaccuracies, inconsistencies, lack of direction, and publication bias. Seven full-text articles fulfilled the stated inclusion, reporting five double-blind, randomized, sham-controlled studies, a case study, and a randomized crossover trial. The results of the reviewed studies suggested that rTMS in MCI patients is safe and effective for enhancing cognitive functions, thus making it a potential therapeutic approach for MCI patients. Changes in functional connectivity within the default mode network (DMN) after targeted rTMS could represent a valuable indicator of treatment response. Finally, high-frequency rTMS over the dorsolateral prefrontal cortex (DLPFC) has been shown to significantly enhance cognitive functions, such as executive performance, together with the increase of functional connectivity within frontoparietal networks. The main limitations were the number of included studies and the exclusion of studies using intermittent theta-burst stimulation, used in studies on Alzheimer's disease. Therefore, neuroimaging techniques in combination with rTMS have been shown to be useful for future network-based, fMRI-guided therapeutic approaches.

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Affiliation(s)

Minoo Sharbafshaaer MRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.S.); (I.G.); (S.B.); (G.T.); (F.E.); (F.T.)
Ilaria Gigi MRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.S.); (I.G.); (S.B.); (G.T.); (F.E.); (F.T.)
Luigi Lavorgna First Division of Neurology, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
Sabrina Esposito First Division of Neurology, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
Simona Bonavita MRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.S.); (I.G.); (S.B.); (G.T.); (F.E.); (F.T.) First Division of Neurology, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
Gioacchino Tedeschi MRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.S.); (I.G.); (S.B.); (G.T.); (F.E.); (F.T.) First Division of Neurology, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
Fabrizio Esposito MRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.S.); (I.G.); (S.B.); (G.T.); (F.E.); (F.T.)
Francesca Trojsi MRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.S.); (I.G.); (S.B.); (G.T.); (F.E.); (F.T.) First Division of Neurology, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy;

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Lv T, You S, Qin R, Hu Z, Ke Z, Yao W, Zhao H, Xu Y, Bai F. Distinct reserve capacity impacts on default-mode network in response to left angular gyrus-navigated repetitive transcranial magnetic stimulation in the prodromal Alzheimer disease. Behav Brain Res 2023;439:114226. [PMID: 36436729 DOI: 10.1016/j.bbr.2022.114226] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/01/2022] [Accepted: 11/23/2022] [Indexed: 11/25/2022]

Affiliation(s)

Tingyu Lv Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China
Shengqi You Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China
Ruomeng Qin Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing 210008, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing 210008, China
Zheqi Hu Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China
Zhihong Ke Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China
Weina Yao Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China
Hui Zhao Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing 210008, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing 210008, China
Yun Xu Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing 210008, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing 210008, China
Feng Bai Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing 210008, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing 210008, China.

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Esposito S, Trojsi F, Cirillo G, de Stefano M, Di Nardo F, Siciliano M, Caiazzo G, Ippolito D, Ricciardi D, Buonanno D, Atripaldi D, Pepe R, D’Alvano G, Mangione A, Bonavita S, Santangelo G, Iavarone A, Cirillo M, Esposito F, Sorbi S, Tedeschi G. Repetitive Transcranial Magnetic Stimulation (rTMS) of Dorsolateral Prefrontal Cortex May Influence Semantic Fluency and Functional Connectivity in Fronto-Parietal Network in Mild Cognitive Impairment (MCI). Biomedicines 2022;10:biomedicines10050994. [PMID: 35625731 PMCID: PMC9138229 DOI: 10.3390/biomedicines10050994] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/17/2022] [Accepted: 04/20/2022] [Indexed: 12/28/2022] Open

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation technique that is increasingly used as a nonpharmacological intervention against cognitive impairment in Alzheimer’s disease (AD) and other dementias. Although rTMS has been shown to modify cognitive performances and brain functional connectivity (FC) in many neurological and psychiatric diseases, there is still no evidence about the possible relationship between executive performances and resting-state brain FC following rTMS in patients with mild cognitive impairment (MCI). In this preliminary study, we aimed to evaluate the possible effects of rTMS of the bilateral dorsolateral prefrontal cortex (DLPFC) in 27 MCI patients randomly assigned to two groups: one group received high-frequency (10 Hz) rTMS (HF-rTMS) for four weeks (n = 11), and the other received sham stimulation (n = 16). Cognitive and psycho-behavior scores, based on the Repeatable Battery for the Assessment of Neuropsychological Status, Beck Depression Inventory-II, Beck Anxiety Inventory, Apathy Evaluation Scale, and brain FC, evaluated by independent component analysis of resting state functional MRI (RS-fMRI) networks, together with the assessment of regional atrophy measures, evaluated by whole-brain voxel-based morphometry (VBM), were measured at baseline, after five weeks, and six months after rTMS stimulation. Our results showed significantly increased semantic fluency (p = 0.026) and visuo-spatial (p = 0.014) performances and increased FC within the salience network (p ≤ 0.05, cluster-level corrected) at the short-term timepoint, and increased FC within the left fronto-parietal network (p ≤ 0.05, cluster-level corrected) at the long-term timepoint, in the treated group but not in the sham group. Conversely, regional atrophy measures did not show significant longitudinal changes between the two groups across six months. Our preliminary findings suggest that targeting DLPFC by rTMS application may lead to a significant long-term increase in FC in MCI patients in a RS network associated with executive functions, and this process might counteract the progressive cortical dysfunction affecting this domain.

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Affiliation(s)

Sabrina Esposito First Division of Neurology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (S.E.); (M.d.S.); (D.I.); (D.R.); (D.B.); (G.D.); (G.T.)
Francesca Trojsi First Division of Neurology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (S.E.); (M.d.S.); (D.I.); (D.R.); (D.B.); (G.D.); (G.T.) Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.) Correspondence: ; Tel.: +39-08-1566-5659
Giovanni Cirillo Division of Human Anatomy, Laboratory of Morphology of Neuronal Networks & Systems Biology, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
Manuela de Stefano First Division of Neurology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (S.E.); (M.d.S.); (D.I.); (D.R.); (D.B.); (G.D.); (G.T.)
Federica Di Nardo Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)
Mattia Siciliano Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)
Giuseppina Caiazzo Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)
Domenico Ippolito First Division of Neurology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (S.E.); (M.d.S.); (D.I.); (D.R.); (D.B.); (G.D.); (G.T.)
Dario Ricciardi First Division of Neurology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (S.E.); (M.d.S.); (D.I.); (D.R.); (D.B.); (G.D.); (G.T.)
Daniela Buonanno First Division of Neurology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (S.E.); (M.d.S.); (D.I.); (D.R.); (D.B.); (G.D.); (G.T.)
Danilo Atripaldi Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)
Roberta Pepe Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)
Giulia D’Alvano First Division of Neurology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (S.E.); (M.d.S.); (D.I.); (D.R.); (D.B.); (G.D.); (G.T.)
Antonella Mangione Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)
Simona Bonavita Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)
Gabriella Santangelo Department of Psychology, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy;
Alessandro Iavarone Neurological Unit, CTO Hospital, AORN Ospedali Dei Colli, 80131 Naples, Italy;
Mario Cirillo Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)
Fabrizio Esposito Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)
Sandro Sorbi IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, 50134 Florence, Italy
Gioacchino Tedeschi First Division of Neurology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (S.E.); (M.d.S.); (D.I.); (D.R.); (D.B.); (G.D.); (G.T.) Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy; (F.D.N.); (M.S.); (G.C.); (D.A.); (R.P.); (A.M.); (S.B.); (M.C.); (F.E.)

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