The Efficacy of High- or Low-Frequency Transcranial Magnetic Stimulation in Alzheimer’s Disease Patients with Behavioral and Psychological Symptoms of…

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Adv Ther. 2021 Oct 29. doi: 10.1007/s12325-021-01964-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Alzheimers disease (AD) is usually accompanied by different degrees of behavioral and psychological symptoms of dementia (BPSD). Transcranial magnetic stimulation (TMS) has been applied for the treatment of AD as a painless and noninvasive therapy. However, the efficacy of repetitive TMS (rTMS) with different frequencies in AD with BPSD remains unknown.

METHODS: A total of 32 AD patients with psychobehavioral symptoms were selected as the study subjects. Among them, 16 patients were included in the high-frequency TMS group with an average disease duration of 6.22 2.55 years. The low-frequency TMS group was gender and age matched with a disease course of 7.02 3.33-year average duration. The high-frequency TMS group received TMS treatment twice per day for 4 weeks under 80% MT stimulation intensity, 10-Hz frequency for 0.5 h each time, and the low-frequency TMS group received TMS treatment of 2-Hz frequency for 0.5 h each time. Neuropsychological status was assessed by the Behavioral Pathology in Alzheimers Disease Rating Scale (BEHAVE-AD) score. The behavioral ability was assessed by the Abilities of Daily Living (ADL) scale; cognitive function was evaluated by Mini-Mental State Examination (MMSE). The levels of amyloid 40 and 42 (A40 and A42) in plasma were detected using a double-antibody sandwich enzyme-linked immunosorbent assay. All patients underwent brain magnetic resonance imaging (MRI) before and after the experiment.

RESULTS: After 2 weeks of treatment, the BEHAVE-AD and ADL scores of the patients in the high-frequency group were significantly lower than those before the treatment, and they continued to decrease after 4 weeks of treatment. The BEHAVE-AD and ADL scores of the low-frequency TMS group were also significantly lower than before treatment. The comparison between groups at different time points showed that the BEHAVE-AD and ADL scores of the patients in the high-frequency group were significantly lower than those of the patients in the low-frequency TMS group. The MMSE of high-frequency TMS-treated patients increased from 14.22 3.55 before treatment to 14.67 2.22 at 2 weeks treatment and 17.33 3.11 at 4 weeks treatment (p < 0.01) in contrast to 14.19 3.47, 14.28 3.41, and 14.49 2.79, respectively, found in the low-frequency TMS group. At week 4, the high-frequency TMS-treated groups plasma A40 did not change compared to that before treatment. No effects on plasma A42 were observed between the high- vs. low-frequency TMS groups. The incidence of adverse reactions during treatment was comparable between groups.

CONCLUSION: These results indicate that high-frequency TMS has the advantages of fast results, good efficacy, and high safety for the treatment of psychobehavioral abnormalities in AD patients. In addition, our study suggests that high-frequency TMS intervention can further improve the cognitive function of AD patients.

PMID:34716559 | DOI:10.1007/s12325-021-01964-8

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The Efficacy of High- or Low-Frequency Transcranial Magnetic Stimulation in Alzheimer's Disease Patients with Behavioral and Psychological Symptoms of...