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Repetitive Transcranial Magnetic Stimulation With H-Coil in Alzheimer's Disease: A Double-Blind, Placebo-Controlled Pilot Study

Focal repetitive transcranial magnetic stimulation (rTMS) has been applied to improve cognition in Alzheimer's disease (AD) with conflicting results. We applied rTMS in AD in a pilot placebo-controlled study using the H2-coil. H-coils are suitable for targeting wider neuronal structures compare...

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Autores principales: Leocani, Letizia, Dalla Costa, Gloria, Coppi, Elisabetta, Santangelo, Roberto, Pisa, Marco, Ferrari, Laura, Bernasconi, Maria Paola, Falautano, Monica, Zangen, Abraham, Magnani, Giuseppe, Comi, Giancarlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930223/
https://www.ncbi.nlm.nih.gov/pubmed/33679572
http://dx.doi.org/10.3389/fneur.2020.614351
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author Leocani, Letizia
Dalla Costa, Gloria
Coppi, Elisabetta
Santangelo, Roberto
Pisa, Marco
Ferrari, Laura
Bernasconi, Maria Paola
Falautano, Monica
Zangen, Abraham
Magnani, Giuseppe
Comi, Giancarlo
author_facet Leocani, Letizia
Dalla Costa, Gloria
Coppi, Elisabetta
Santangelo, Roberto
Pisa, Marco
Ferrari, Laura
Bernasconi, Maria Paola
Falautano, Monica
Zangen, Abraham
Magnani, Giuseppe
Comi, Giancarlo
author_sort Leocani, Letizia
collection PubMed
description Focal repetitive transcranial magnetic stimulation (rTMS) has been applied to improve cognition in Alzheimer's disease (AD) with conflicting results. We applied rTMS in AD in a pilot placebo-controlled study using the H2-coil. H-coils are suitable for targeting wider neuronal structures compared with standard focal coils, in particular the H2-coil stimulates simultaneously the frontal-parietal-temporal lobes bilaterally. Thirty patients (mean age 70.9 year, SD 8.1; mean MMSE score 16.9, SD 5.5) were randomized to sham or real 10 Hz rTMS stimulation with the H2-coil. Each patient underwent 3 sessions/week for 4 weeks, followed by 4 weeks with maintenance treatment (1 session/week). Primary outcome was improvement of ADAS-cog at 4 and 8 weeks compared with baseline. A trend toward an improved ADAS-cog score over time was observed for patients undergoing real rTMS, with actively treated patients experiencing a mean decrease of −1.01 points at the ADAS-Cog scale score per time point (95% CIs −0.02 to −3.13, p < 0.04). This trend was no longer evident 2 months after the end of treatment. Real rTMS showed no significant effect on MMSE and BDI changes over time. These preliminary findings suggest that rTMS with H-coil is feasible and safe in patients with probable AD and might provide beneficial, even though transient, effects on cognition. This study prompts larger studies in the early stages of AD, combining rTMS and cognitive rehabilitation. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04562506.
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spelling pubmed-79302232021-03-05 Repetitive Transcranial Magnetic Stimulation With H-Coil in Alzheimer's Disease: A Double-Blind, Placebo-Controlled Pilot Study Leocani, Letizia Dalla Costa, Gloria Coppi, Elisabetta Santangelo, Roberto Pisa, Marco Ferrari, Laura Bernasconi, Maria Paola Falautano, Monica Zangen, Abraham Magnani, Giuseppe Comi, Giancarlo Front Neurol Neurology Focal repetitive transcranial magnetic stimulation (rTMS) has been applied to improve cognition in Alzheimer's disease (AD) with conflicting results. We applied rTMS in AD in a pilot placebo-controlled study using the H2-coil. H-coils are suitable for targeting wider neuronal structures compared with standard focal coils, in particular the H2-coil stimulates simultaneously the frontal-parietal-temporal lobes bilaterally. Thirty patients (mean age 70.9 year, SD 8.1; mean MMSE score 16.9, SD 5.5) were randomized to sham or real 10 Hz rTMS stimulation with the H2-coil. Each patient underwent 3 sessions/week for 4 weeks, followed by 4 weeks with maintenance treatment (1 session/week). Primary outcome was improvement of ADAS-cog at 4 and 8 weeks compared with baseline. A trend toward an improved ADAS-cog score over time was observed for patients undergoing real rTMS, with actively treated patients experiencing a mean decrease of −1.01 points at the ADAS-Cog scale score per time point (95% CIs −0.02 to −3.13, p < 0.04). This trend was no longer evident 2 months after the end of treatment. Real rTMS showed no significant effect on MMSE and BDI changes over time. These preliminary findings suggest that rTMS with H-coil is feasible and safe in patients with probable AD and might provide beneficial, even though transient, effects on cognition. This study prompts larger studies in the early stages of AD, combining rTMS and cognitive rehabilitation. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04562506. Frontiers Media S.A. 2021-02-18 /pmc/articles/PMC7930223/ /pubmed/33679572 http://dx.doi.org/10.3389/fneur.2020.614351 Text en Copyright © 2021 Leocani, Dalla Costa, Coppi, Santangelo, Pisa, Ferrari, Bernasconi, Falautano, Zangen, Magnani and Comi. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Leocani, Letizia
Dalla Costa, Gloria
Coppi, Elisabetta
Santangelo, Roberto
Pisa, Marco
Ferrari, Laura
Bernasconi, Maria Paola
Falautano, Monica
Zangen, Abraham
Magnani, Giuseppe
Comi, Giancarlo
Repetitive Transcranial Magnetic Stimulation With H-Coil in Alzheimer's Disease: A Double-Blind, Placebo-Controlled Pilot Study
title Repetitive Transcranial Magnetic Stimulation With H-Coil in Alzheimer's Disease: A Double-Blind, Placebo-Controlled Pilot Study
title_full Repetitive Transcranial Magnetic Stimulation With H-Coil in Alzheimer's Disease: A Double-Blind, Placebo-Controlled Pilot Study
title_fullStr Repetitive Transcranial Magnetic Stimulation With H-Coil in Alzheimer's Disease: A Double-Blind, Placebo-Controlled Pilot Study
title_full_unstemmed Repetitive Transcranial Magnetic Stimulation With H-Coil in Alzheimer's Disease: A Double-Blind, Placebo-Controlled Pilot Study
title_short Repetitive Transcranial Magnetic Stimulation With H-Coil in Alzheimer's Disease: A Double-Blind, Placebo-Controlled Pilot Study
title_sort repetitive transcranial magnetic stimulation with h-coil in alzheimer's disease: a double-blind, placebo-controlled pilot study
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930223/
https://www.ncbi.nlm.nih.gov/pubmed/33679572
http://dx.doi.org/10.3389/fneur.2020.614351
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