Network-targeted rTMS for treatment of Alzheimer’s disease (AD) using a personalized 3D-printed frame
Sungshin Kim1 (email@example.com), Young Hee Jung, Hyemin Jang, Sungbeen Park, Duk L Na; 1Hanyang University
We explore the efficacy of a 20-Hz hippocampal network-targeted repetitive transcranial magnetic stimulation (rTMS) protocol for treating early AD patients. We conducted an evaluator-blinded, randomized, and sham-controlled clinical trial involving 44 early-stage AD patients, who were confirmed by amyloid deposition on PET scans or cerebrospinal fluid tests. The patients were randomly assigned to the rTMS treatment group or sham control group. The intervention consisted of twenty rTMS sessions over four weeks, targeting the left parietal area connected to the hippocampus, guided by individual fMRI maps. A personalized 3D-printed frame was utilized for precise coil placement. The primary outcome was measured by the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) score at four and eight weeks post-baseline. Secondary measures included the Clinical Dementia Rating-Sum of Boxes (CDR-SB), the Seoul-Instrumental Activity Daily Living (S-IADL) scales, and resting-state fMRI connectivity between the hippocampus and cortical areas. Among 30 patients who completed the entire 4-week sessions, those in the rTMS group demonstrated significant improvement (i.e., reduction) in primary and secondary outcomes compared to the sham group. Furthermore, the improvement of the ADAS-Cog immediately after the 4-week sessions was associated with increased functional connectivity between the hippocampus and precuneus. These findings support using rTMS as a non-pharmacological approach to treating AD, highlighting its potential to induce beneficial neural plasticity within the hippocampal-cortical network. Finally, using personalized 3-D printed frames represents a promising innovation that could improve the precision and efficacy of rTMS treatments, making it a viable option in clinical settings without depending on neuronavigation technology.
Topic Area: METHODS: Other
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April 13–16 | 2024