Episodic memory effects of gamma frequency precuneus transcranial magnetic stimulation in Alzheimer's disease: A randomized multiple baseline study

IF 2 4区 心理学 Q2 PSYCHOLOGY
Artemis Traikapi, Ioanna Kalli, Andrea Kyriakou, Elena Stylianou, Rafaella Tereza Symeou, Akrivi Kardama, Yiolanda Panayiota Christou, Phivos Phylactou, Nikos Konstantinou
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引用次数: 2

Abstract

Episodic memory decline is the prominent neuropsychological feature of typical Alzheimer's Disease (AD), for which current treatments have a limited clinical response. Recently, gamma entrainment therapy has been used as a non-invasive treatment in AD, providing evidence that it may have the potential to alleviate brain pathology and improve cognitive function in AD patients. At the same time, the precuneus (PC) has been recognized as a key area involved in AD related memory deficits and as a key node of the Default Mode Network. This study aimed to investigate the effectiveness of a 40 Hz Transcranial Magnetic Stimulation (TMS) intervention, delivered bilaterally to the precuneus for 10 days, in improving the patients' episodic memory performance. Secondary outcome variables investigated included general cognitive function, semantic and spatial memory, as well as attention and executive function. A concurrent multiple baseline design across five cases was employed. Four patients completed the study. Visual analysis combined with effect size indices were used to evaluate changes across phases. An increase in the average level of immediate recalled words was observed in three out of four patients. Effect size indices indicated significant improvement of attention skills in two patients. No treatment effect was observed for semantic and visual memory, or for executive function. An immediate treatment effect was observed in all patients' general cognitive function as assessed with the Alzheimer's Disease Assessment Scale (mean reduction of 5 points), which was maintained and improved further three months post-treatment. The neuropsychological evaluations indicated improved performance three months post-treatment in immediate and delayed recall, attention, phonological verbal fluency, anxiety, and neuropsychiatric symptoms. This study provides preliminary evidence for the efficacy of a novel non-pharmacological treatment using gamma-band TMS in addressing cognitive dysfunction in AD.

阿尔茨海默病γ频率楔前叶经颅磁刺激的情景记忆效应:一项随机多基线研究
情景记忆衰退是典型阿尔茨海默病(AD)的突出神经心理特征,目前的治疗方法临床疗效有限。近年来,伽玛夹带治疗已被作为一种非侵入性治疗AD的方法,有证据表明它可能具有缓解AD患者脑部病理和改善认知功能的潜力。同时,楔前叶(PC)被认为是参与AD相关记忆缺陷的关键区域,也是默认模式网络的关键节点。本研究旨在探讨40 Hz经颅磁刺激(TMS)干预双侧楔前叶10天对改善患者情景记忆表现的有效性。次要结果变量包括一般认知功能,语义和空间记忆,以及注意力和执行功能。在5个案例中采用并行多基线设计。4名患者完成了这项研究。采用目视分析结合效应大小指数评价各阶段的变化。在四名患者中,有三名患者的即时记忆单词的平均水平有所提高。效应大小指数显示两名患者的注意技能有显著改善。没有观察到治疗对语义和视觉记忆或执行功能的影响。根据阿尔茨海默病评估量表(Alzheimer's Disease Assessment Scale)评估,所有患者的一般认知功能均观察到立即的治疗效果(平均降低5分),并在治疗后3个月保持并进一步改善。神经心理学评估显示,治疗后3个月,患者在即时和延迟回忆、注意力、语音语言流畅性、焦虑和神经精神症状方面的表现有所改善。本研究为一种新的非药物治疗方法-伽玛带经颅磁刺激治疗AD认知功能障碍的疗效提供了初步证据。
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来源期刊
Journal of Neuropsychology
Journal of Neuropsychology 医学-心理学
CiteScore
4.50
自引率
4.50%
发文量
34
审稿时长
>12 weeks
期刊介绍: The Journal of Neuropsychology publishes original contributions to scientific knowledge in neuropsychology including: • clinical and research studies with neurological, psychiatric and psychological patient populations in all age groups • behavioural or pharmacological treatment regimes • cognitive experimentation and neuroimaging • multidisciplinary approach embracing areas such as developmental psychology, neurology, psychiatry, physiology, endocrinology, pharmacology and imaging science The following types of paper are invited: • papers reporting original empirical investigations • theoretical papers; provided that these are sufficiently related to empirical data • review articles, which need not be exhaustive, but which should give an interpretation of the state of research in a given field and, where appropriate, identify its clinical implications • brief reports and comments • case reports • fast-track papers (included in the issue following acceptation) reaction and rebuttals (short reactions to publications in JNP followed by an invited rebuttal of the original authors) • special issues.
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