Download PDF
Nervenheilkunde 2015; 34(12): 994-997
DOI: 10.1055/s-0038-1627654
Hirnstimulation
Schattauer GmbH

Alzheimer Demenz und der therapeutische Einsatz von rTMS

rTMS in Alzheimer`s disease
T. Schulz
1   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Rostock
,
P. M. Kreuzer
2   Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität Regensburg am Bezirksklinikum, Regensburg
,
B. Langguth
2   Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität Regensburg am Bezirksklinikum, Regensburg
,
J.-P. Lefaucheur
3   Department of Physiology, Henri Mondor Hospital, Assistance Publique – Hôpitaux de Paris, Créteil, France
4   EA 4391, Nerve Excitability and Therapeutic team, Faculty of Medicine, Paris Est Créteil University, Créteil, France
,
J. Höppner
1   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Rostock
› Author Affiliations
Further Information

Publication History

eingegangen am: 21 September 2015

angenommen am: 21 September 2015

Publication Date:
22 January 2018 (online)

    Permissions and Reprints

Zusammenfassung

Gegenstand und Ziel: Es soll ein Überblick über die Studienlage zur rTMS bei Alzheimer Demenz (AD) gegeben werden. Vor dem Hintergrund limitierter Therapiemöglichkeiten sind innovative, nebenwirkungsarme Behandlungen bei AD gefragt. Stellt die rTMS eine Therapiealternative oder -möglichkeit dar? Material und Methoden: Anhand einer pubmed-Recherche wurden Studien zur rTMS bei AD hinsichtlich eingeschlossener Patienten, Stimulationsparameter und Ergebnissen verglichen. Ergebnisse: Es liegen acht Studien zur Anwendung der rTMS bei Patienten mit einer AD vor. Insgesamt zeigten sich Verbesserungen unterschiedlicher kognitiver Funktionen und Reduktionen der klinischen Beeinträchtigung der Patienten. Die Studienlage präsentiert sich aber sowohl hinsichtlich der Patientenanzahl als auch bezüglich der Stimulationsparameter und der während oder nach der rTMS getesteten kognitiven Funktionen sehr heterogen. Schlussfolgerungen: Aufgrund dieser Limitationen kann keine generelle Empfehlung für eine rTMS-Behandlung bei AD ausgesprochen werden. Die Vorarbeiten rechtfertigen aber weitere klinische Anwendungsstudien an größeren Fallzahlen.

Summary

Objectives: An overview about the current data concerning rTMS in Alzheimer`s disease (AD) is given. Because of the limited therapeutic options, new innovative treatment options with low side effects are required in AD. Does the rTMS represent an alternative therapy option? Material and methods: Based on a pubmed search, rTMS studies in AD were compared regarding included patients, stimulation parameters and results. Results: Eight studies applying rTMS in patients with AD are currently available. In summary, improvements of different cognitive functions as well as a reduction of the clinical impairment were shown. However, the studies are very heterogeneous regarding the small sample sizes, the applied stimulation parameters and the assessment of cognitive functioning, which were investigated during or at the end of rTMS series. Conclusions: Taking into account the limitations of available studies, rTMS currently cannot be recommended as a treatment option for AD. However, the preliminary data justify further clinical studies involving larger sample sizes.

Schlüsselwörter

Alzheimer Demenz - rTMS - Kognition

Keywords

Alzheimer´s disease - rTMS - cognition
 

  • Literatur

  • 1 Schneider LS. Rethinking the Food and Drug Administration’s 2013 guidance on developing drugs for early-stage Alzheimer’s disease. Alzheimers Dement 2014; 10 (02) 247-50.
    CrossrefPubMedGoogle Scholar
  • 2 Guse B, Falkai P, Wobrock T. Cognitive effects of high-frequency repetitive transcranial magnetic stimulation: a systematic review. J Neural Transm 2010; 117 (01) 105-22.
    CrossrefPubMedGoogle Scholar
  • 3 Lefaucheur JP. et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol 2014; 125 (11) 2150-206.
    CrossrefPubMedGoogle Scholar
  • 4 Ahmed MA. et al. Effects of low versus high frequencies of repetitive transcranial magnetic stimulation on cognitive function and cortical excitability in Alzheimer’s dementia. J Neurol 2012; 259 (01) 83-92.
    CrossrefPubMedGoogle Scholar
  • 5 Bentwich J. et al. Beneficial effect of repetitive transcranial magnetic stimulation combined with cognitive training for the treatment of Alzheimer’s disease: a proof of concept study. J Neural Transm 2011; 118 (03) 463-71.
    CrossrefPubMedGoogle Scholar
  • 6 Cotelli M. et al. Improved language performance in Alzheimer disease following brain stimulation. J Neurol Neurosurg Psychiatry 2011; 82 (07) 794-7.
    CrossrefPubMedGoogle Scholar
  • 7 Cotelli M. et al. Effect of transcranial magnetic stimulation on action naming in patients with Alzheimer disease. Arch Neurol 2006; 63 (11) 1602-4.
    CrossrefPubMedGoogle Scholar
  • 8 Cotelli M. et al. Transcranial magnetic stimulation improves naming in Alzheimer disease patients at different stages of cognitive decline. Eur J Neurol 2008; 15 (12) 1286-92.
    CrossrefPubMedGoogle Scholar
  • 9 Eliasova I. et al. Non-invasive brain stimulation of the right inferior frontal gyrus may improve attention in early Alzheimer’s disease: a pilot study. J Neurol Sci 2014; 346 (1–2): 318-22.
    CrossrefPubMedGoogle Scholar
  • 10 Rabey JM. et al. Repetitive transcranial magnetic stimulation combined with cognitive training is a safe and effective modality for the treatment of Alzheimer’s disease: a randomized, double-blind study. J Neural Transm 2013; 120 (05) 813-9.
    CrossrefPubMedGoogle Scholar
  • 11 Rutherford GB. et al. Short and long-term effects of rTMS treatment on Alzheimer’s Disease at different stages: A Pilot Study. J Exp Neurosci 2015; 09: 43-51.
    Google Scholar
  • 12 Lim HK. et al. Altered verbal working memory process in patients with Alzheimer’s disease: an fMRI investigation. Neuropsychobiology 2008; 57 (04) 181-7.
    CrossrefPubMedGoogle Scholar
  • 13 Mottaghy FM. et al. Modulation of the neuronal circuitry subserving working memory in healthy human subjects by repetitive transcranial magnetic stimulation. Neurosci Lett 2000; 280 (03) 167-70.
    CrossrefPubMedGoogle Scholar
  • 14 Mottaghy FM. et al. Modulation of a brain-behavior relationship in verbal working memory by rTMS. Brain Res Cogn Brain Res 2003; 15 (03) 241-9.
    CrossrefPubMedGoogle Scholar
  • 15 Anderkova L, Rektorova I. Cognitive effects of repetitive transcranial magnetic stimulation in patients with neurodegenerative diseases – clinician’s perspective. J Neurol Sci 2014; 339 (1–2): 15-25.
    CrossrefPubMedGoogle Scholar
  • 16 Ahmed Z, Wieraszko A. Modulation of learning and hippocampal, neuronal plasticity by repetitive transcranial magnetic stimulation (rTMS). Bioelectromagnetics 2006; 27 (04) 288-94.
    CrossrefPubMedGoogle Scholar
  • 17 Balaz M. et al. The effect of cortical repetitive transcranial magnetic stimulation on cognitive event-related potentials recorded in the subthalamic nucleus. Exp Brain Res 2010; 203 (02) 317-27.
    CrossrefPubMedGoogle Scholar
  • 18 Rego SR. et al. Effects of transcranial magnetic stimulation on the cognitive event-related potential p300: a literature review. Clin EEG Neurosci 2012; 43 (04) 285-90.
    CrossrefPubMedGoogle Scholar
  • 19 Strafella AP. et al. Repetitive transcranial magnetic stimulation of the human prefrontal cortex induces dopamine release in the caudate nucleus. J Neurosci 2001; 21 (15) RC157.
    CrossrefPubMedGoogle Scholar
  • 20 Brunoni AR, Boggio PS, Fregni F. Can the ‘yin and yang’ BDNF hypothesis be used to predict the effects of rTMS treatment in neuropsychiatry?. Med Hypotheses 2008; 71 (02) 279-82.
    CrossrefPubMedGoogle Scholar
  • 21 Wang F. et al. The neuroprotection of repetitive transcranial magnetic stimulation pre-treatment in vascular dementia rats. J Mol Neurosci 2015; 56 (01) 198-204.
    CrossrefPubMedGoogle Scholar
  • 22 Ueyama E. et al. Chronic repetitive transcranial magnetic stimulation increases hippocampal neurogenesis in rats. Psychiatry Clin Neurosci 2011; 65 (01) 77-81.
    CrossrefPubMedGoogle Scholar
  • 23 Li CT. et al. Antidepressant mechanism of add-on repetitive transcranial magnetic stimulation in medication-resistant depression using cerebral glucose metabolism. J Affect Disord 2010; 127 (1–3): 219-29.
    CrossrefPubMedGoogle Scholar
  • 24 Knoch D. et al. Lateralized and frequency-dependent effects of prefrontal rTMS on regional cerebral blood flow. Neuroimage 2006; 31 (02) 641-8.
    CrossrefPubMedGoogle Scholar