Macro and micro structural preservation of grey matter integrity after 24 weeks of rTMS in Alzheimer's disease patients: a pilot study

Alzheimers Res Ther. 2024 Jul 5;16(1):152. doi: 10.1186/s13195-024-01501-z.

Abstract

Alzheimer's Disease (AD) is characterized by structural and functional dysfunction involving the Default Mode Network (DMN), for which the Precuneus (PC) is a key node. We proposed a randomized double-blind pilot study to determine neurobiological changes after 24 weeks of PC-rTMS in patients with mild-to-moderate AD. Sixteen patients were randomly assigned to SHAM or PC-rTMS, and received an intensive 2-weeks course with daily rTMS sessions, followed by a maintenance phase in which rTMS has been applied once a week. Before and after the treatment structural and functional MRIs were collected. Our results showed macro- and micro-structural preservation in PC-rTMS compared to SHAM-rTMS group after 24 weeks of treatment, correlated to an increase of functional connectivity (FC) within the PC in the PC-rTMS group. Even if preliminary, these results trigger the possibility of using PC-rTMS to arrest atrophy progression by manipulating distributed network connectivity patterns.

Keywords: Alzheimer’s disease; Brain plasticity; Cortex; Default mode network; Microstructural; Precuneus; Transcranial magnetic stimulation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alzheimer Disease* / diagnostic imaging
  • Alzheimer Disease* / pathology
  • Alzheimer Disease* / therapy
  • Double-Blind Method
  • Female
  • Gray Matter* / diagnostic imaging
  • Gray Matter* / pathology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Parietal Lobe / diagnostic imaging
  • Parietal Lobe / pathology
  • Pilot Projects
  • Transcranial Magnetic Stimulation* / methods
  • Treatment Outcome