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A comprehensive review of transcranial magnetic stimulation in secondary dementia
Although primary degenerative diseases are the main cause of dementia, a non-negligible proportion of patients is affected by a secondary and potentially treatable cognitive disorder. Therefore, diagnostic tools able to early identify and monitor them and to predict the response to treatment are nee...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549917/ https://www.ncbi.nlm.nih.gov/pubmed/36225892 http://dx.doi.org/10.3389/fnagi.2022.995000 |
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author | Lanza, Giuseppe Fisicaro, Francesco Dubbioso, Raffaele Ranieri, Federico Chistyakov, Andrei V. Cantone, Mariagiovanna Pennisi, Manuela Grasso, Alfio Antonio Bella, Rita Di Lazzaro, Vincenzo |
author_facet | Lanza, Giuseppe Fisicaro, Francesco Dubbioso, Raffaele Ranieri, Federico Chistyakov, Andrei V. Cantone, Mariagiovanna Pennisi, Manuela Grasso, Alfio Antonio Bella, Rita Di Lazzaro, Vincenzo |
author_sort | Lanza, Giuseppe |
collection | PubMed |
description | Although primary degenerative diseases are the main cause of dementia, a non-negligible proportion of patients is affected by a secondary and potentially treatable cognitive disorder. Therefore, diagnostic tools able to early identify and monitor them and to predict the response to treatment are needed. Transcranial magnetic stimulation (TMS) is a non-invasive neurophysiological technique capable of evaluating in vivo and in “real time” the motor areas, the cortico-spinal tract, and the neurotransmission pathways in several neurological and neuropsychiatric disorders, including cognitive impairment and dementia. While consistent evidence has been accumulated for Alzheimer’s disease, other degenerative cognitive disorders, and vascular dementia, to date a comprehensive review of TMS studies available in other secondary dementias is lacking. These conditions include, among others, normal-pressure hydrocephalus, multiple sclerosis, celiac disease and other immunologically mediated diseases, as well as a number of inflammatory, infective, metabolic, toxic, nutritional, endocrine, sleep-related, and rare genetic disorders. Overall, we observed that, while in degenerative dementia neurophysiological alterations might mirror specific, and possibly primary, neuropathological changes (and hence be used as early biomarkers), this pathogenic link appears to be weaker for most secondary forms of dementia, in which neurotransmitter dysfunction is more likely related to a systemic or diffuse neural damage. In these cases, therefore, an effort toward the understanding of pathological mechanisms of cognitive impairment should be made, also by investigating the relationship between functional alterations of brain circuits and the specific mechanisms of neuronal damage triggered by the causative disease. Neurophysiologically, although no distinctive TMS pattern can be identified that might be used to predict the occurrence or progression of cognitive decline in a specific condition, some TMS-associated measures of cortical function and plasticity (such as the short-latency afferent inhibition, the short-interval intracortical inhibition, and the cortical silent period) might add useful information in most of secondary dementia, especially in combination with suggestive clinical features and other diagnostic tests. The possibility to detect dysfunctional cortical circuits, to monitor the disease course, to probe the response to treatment, and to design novel neuromodulatory interventions in secondary dementia still represents a gap in the literature that needs to be explored. |
format | Online Article Text |
id | pubmed-9549917 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95499172022-10-11 A comprehensive review of transcranial magnetic stimulation in secondary dementia Lanza, Giuseppe Fisicaro, Francesco Dubbioso, Raffaele Ranieri, Federico Chistyakov, Andrei V. Cantone, Mariagiovanna Pennisi, Manuela Grasso, Alfio Antonio Bella, Rita Di Lazzaro, Vincenzo Front Aging Neurosci Neuroscience Although primary degenerative diseases are the main cause of dementia, a non-negligible proportion of patients is affected by a secondary and potentially treatable cognitive disorder. Therefore, diagnostic tools able to early identify and monitor them and to predict the response to treatment are needed. Transcranial magnetic stimulation (TMS) is a non-invasive neurophysiological technique capable of evaluating in vivo and in “real time” the motor areas, the cortico-spinal tract, and the neurotransmission pathways in several neurological and neuropsychiatric disorders, including cognitive impairment and dementia. While consistent evidence has been accumulated for Alzheimer’s disease, other degenerative cognitive disorders, and vascular dementia, to date a comprehensive review of TMS studies available in other secondary dementias is lacking. These conditions include, among others, normal-pressure hydrocephalus, multiple sclerosis, celiac disease and other immunologically mediated diseases, as well as a number of inflammatory, infective, metabolic, toxic, nutritional, endocrine, sleep-related, and rare genetic disorders. Overall, we observed that, while in degenerative dementia neurophysiological alterations might mirror specific, and possibly primary, neuropathological changes (and hence be used as early biomarkers), this pathogenic link appears to be weaker for most secondary forms of dementia, in which neurotransmitter dysfunction is more likely related to a systemic or diffuse neural damage. In these cases, therefore, an effort toward the understanding of pathological mechanisms of cognitive impairment should be made, also by investigating the relationship between functional alterations of brain circuits and the specific mechanisms of neuronal damage triggered by the causative disease. Neurophysiologically, although no distinctive TMS pattern can be identified that might be used to predict the occurrence or progression of cognitive decline in a specific condition, some TMS-associated measures of cortical function and plasticity (such as the short-latency afferent inhibition, the short-interval intracortical inhibition, and the cortical silent period) might add useful information in most of secondary dementia, especially in combination with suggestive clinical features and other diagnostic tests. The possibility to detect dysfunctional cortical circuits, to monitor the disease course, to probe the response to treatment, and to design novel neuromodulatory interventions in secondary dementia still represents a gap in the literature that needs to be explored. Frontiers Media S.A. 2022-09-26 /pmc/articles/PMC9549917/ /pubmed/36225892 http://dx.doi.org/10.3389/fnagi.2022.995000 Text en Copyright © 2022 Lanza, Fisicaro, Dubbioso, Ranieri, Chistyakov, Cantone, Pennisi, Grasso, Bella and Di Lazzaro. https://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 | Neuroscience Lanza, Giuseppe Fisicaro, Francesco Dubbioso, Raffaele Ranieri, Federico Chistyakov, Andrei V. Cantone, Mariagiovanna Pennisi, Manuela Grasso, Alfio Antonio Bella, Rita Di Lazzaro, Vincenzo A comprehensive review of transcranial magnetic stimulation in secondary dementia |
title | A comprehensive review of transcranial magnetic stimulation in secondary dementia |
title_full | A comprehensive review of transcranial magnetic stimulation in secondary dementia |
title_fullStr | A comprehensive review of transcranial magnetic stimulation in secondary dementia |
title_full_unstemmed | A comprehensive review of transcranial magnetic stimulation in secondary dementia |
title_short | A comprehensive review of transcranial magnetic stimulation in secondary dementia |
title_sort | comprehensive review of transcranial magnetic stimulation in secondary dementia |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549917/ https://www.ncbi.nlm.nih.gov/pubmed/36225892 http://dx.doi.org/10.3389/fnagi.2022.995000 |
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