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Repetitive Transcranial Magnetic Stimulation (rTMS) of Dorsolateral Prefrontal Cortex May Influence Semantic Fluency and Functional Connectivity in Fronto-Parietal Network in Mild Cognitive Impairment (MCI).

Esposito, S; Trojsi, F; Cirillo, G; de Stefano, M; Di Nardo, F; Siciliano, M; Caiazzo, G; Ippolito, D; Ricciardi, D; Buonanno, D; et al. Esposito, S; Trojsi, F; Cirillo, G; de Stefano, M; Di Nardo, F; Siciliano, M; Caiazzo, G; Ippolito, D; Ricciardi, D; Buonanno, D; Atripaldi, D; Pepe, R; D'Alvano, G; Mangione, A; Bonavita, S; Santangelo, G; Iavarone, A; Cirillo, M; Esposito, F; Sorbi, S; Tedeschi, G (2022) Repetitive Transcranial Magnetic Stimulation (rTMS) of Dorsolateral Prefrontal Cortex May Influence Semantic Fluency and Functional Connectivity in Fronto-Parietal Network in Mild Cognitive Impairment (MCI). Biomedicines, 10 (5). ISSN 2227-9059 https://doi.org/10.3390/biomedicines10050994
SGUL Authors: Siciliano, Mattia

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Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation technique that is increasingly used as a nonpharmacological intervention against cognitive impairment in Alzheimer's disease (AD) and other dementias. Although rTMS has been shown to modify cognitive performances and brain functional connectivity (FC) in many neurological and psychiatric diseases, there is still no evidence about the possible relationship between executive performances and resting-state brain FC following rTMS in patients with mild cognitive impairment (MCI). In this preliminary study, we aimed to evaluate the possible effects of rTMS of the bilateral dorsolateral prefrontal cortex (DLPFC) in 27 MCI patients randomly assigned to two groups: one group received high-frequency (10 Hz) rTMS (HF-rTMS) for four weeks (n = 11), and the other received sham stimulation (n = 16). Cognitive and psycho-behavior scores, based on the Repeatable Battery for the Assessment of Neuropsychological Status, Beck Depression Inventory-II, Beck Anxiety Inventory, Apathy Evaluation Scale, and brain FC, evaluated by independent component analysis of resting state functional MRI (RS-fMRI) networks, together with the assessment of regional atrophy measures, evaluated by whole-brain voxel-based morphometry (VBM), were measured at baseline, after five weeks, and six months after rTMS stimulation. Our results showed significantly increased semantic fluency (p = 0.026) and visuo-spatial (p = 0.014) performances and increased FC within the salience network (p ≤ 0.05, cluster-level corrected) at the short-term timepoint, and increased FC within the left fronto-parietal network (p ≤ 0.05, cluster-level corrected) at the long-term timepoint, in the treated group but not in the sham group. Conversely, regional atrophy measures did not show significant longitudinal changes between the two groups across six months. Our preliminary findings suggest that targeting DLPFC by rTMS application may lead to a significant long-term increase in FC in MCI patients in a RS network associated with executive functions, and this process might counteract the progressive cortical dysfunction affecting this domain.

Item Type: Article
Additional Information: Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Keywords: brain networks, mild cognitive impairment, rTMS, resting state functional MRI, mild cognitive impairment, rTMS, resting state functional MRI, brain networks
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Biomedicines
ISSN: 2227-9059
Language: eng
Dates:
DateEvent
25 April 2022Published
20 April 2022Accepted
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 35625731
Web of Science ID: WOS:000801771700001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/114897
Publisher's version: https://doi.org/10.3390/biomedicines10050994

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