Multi-networks connectivity at baseline predicts the clinical efficacy of left angular gyrus-navigated rTMS in the spectrum of Alzheimer's disease: A sham-controlled study.

Autor: Chen HF; Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.; Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China., Sheng XN; Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China., Yang ZY; Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China., Shao PF; Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China., Xu HH; Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China., Qin RM; Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China., Zhao H; Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China., Bai F; Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.; Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.; Geriatric Medicine Center, Affiliated Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Jazyk: angličtina
Zdroj: CNS neuroscience & therapeutics [CNS Neurosci Ther] 2023 Aug; Vol. 29 (8), pp. 2267-2280. Date of Electronic Publication: 2023 Mar 21.
DOI: 10.1111/cns.14177
Abstrakt: Introduction: Neuro-navigated repetitive transcranial magnetic stimulation (rTMS) is effective in alleviating cognitive deficits in Alzheimer's disease (AD). However, the strategy for target determination and the mechanisms for cognitive improvement remain unclear.
Methods: One hundred and thirteen elderly subjects were recruited in this study, including both cross-sectional (n = 79) and longitudinal experiments (the rTMS group: n = 24; the sham group: n = 10). The cross-sectional experiment explored the precise intervention target based on the cortical-hippocampal network. The longitudinal experiment investigated the clinical efficacy of neuro-navigated rTMS treatment over a four-week period and explored its underlying neural mechanism using seed-based and network-based analysis. Finally, we applied connectome-based predictive modeling to predict the rTMS response using these functional features at baseline.
Results: RTMS at a targeted site of the left angular gyrus (MNI: -45, -67, 38) significantly induced cognitive improvement in memory and language function (p < 0.001). The improved cognition correlated with the default mode network (DMN) subsystems. Furthermore, the connectivity patterns of DMN subsystems (r = 0.52, p = 0.01) or large-scale networks (r = 0.85, p = 0.001) at baseline significantly predicted the Δ language cognition after the rTMS treatment. The connectivity patterns of DMN subsystems (r = 0.47, p = 0.019) or large-scale networks (r = 0.80, p = 0.001) at baseline could predict the Δ memory cognition after the rTMS treatment.
Conclusion: These findings suggest that neuro-navigated rTMS targeting the left angular gyrus could improve cognitive function in AD patients. Importantly, dynamic regulation of the intra- and inter-DMN at baseline may represent a potential predictor for favorable rTMS treatment response in patients with cognitive impairment.
(© 2023 The Authors. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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