Multisite rTMS combined with cognitive training modulates effective connectivity in patients with Alzheimer's disease.

IF 3.4 3区 医学 Q2 NEUROSCIENCES Frontiers in Neural Circuits Pub Date : 2023-09-05 eCollection Date: 2023-01-01 DOI:10.3389/fncir.2023.1202671
Yuanyuan Qin, Li Ba, Fengxia Zhang, Si Jian, Tian Tian, Min Zhang, Wenzhen Zhu
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Abstract

Purpose: To investigate the effective connectivity (EC) changes after multisite repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training (COG).

Method: We selected 51 patients with mild or moderate Alzheimer's disease (AD) and delivered 10 Hz rTMS over the left dorsal lateral prefrontal cortex (DLPFC) and the lateral temporal lobe (LTL) combined with COG or sham stimulation for 4 weeks. The selected AD patients were divided into real (real rTMS+COG, n = 11) or sham (sham rTMS+COG, n = 8) groups to undergo neuropsychological assessment, resting-state fMRI, and 3D brain structural imaging before (T0), immediately at the end of treatment (T4), and 4 weeks after treatment (T8). A 2 × 3 factorial design with "time" as the within-subjects factor (three levels: T0, T4, and T8) and "group" as the between-subjects factor (two levels: real and sham) was used to investigate the EC changes related to the stimulation targets in the rest of the brain, as well as the causal interactions among seven resting-state networks based on Granger causality analysis (GCA).

Results: At the voxel level, the EC changes from the left DLPFC out to the left inferior parietal lobe and the left superior frontal gyrus, as well as from the left LTL out to the left orbital frontal cortex, had a significant group × time interaction effect. At the network level, a significant interaction effect was identified in the increase in EC from the limbic network out to the default mode network. The decrease in EC at the voxel level and the increase in EC at the network level were both associated with the improved ability to perform activities of daily living and cognitive function.

Conclusion: Multisite rTMS combined with cognitive training can modulate effective connectivity in patients with AD, resulting in improved ability to perform activities of daily living and cognitive function.

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多部位rTMS与认知训练相结合可调节阿尔茨海默病患者的有效连接。
目的:研究多部位重复性经颅磁刺激(rTMS)联合认知训练(COG)后的有效连接(EC)变化刺激4周。选择的AD患者被分为真实组(真实rTMS+COG,n=11)或假组(假rTMS+CAG,n=8),在治疗前(T0)、治疗结束时(T4)和治疗后4周(T8)接受神经心理评估、静息状态fMRI和3D脑结构成像。采用2×3析因设计,以“时间”为受试者内因素(三个水平:T0、T4和T8),以“组”为受检者间因素(两个水平:真实和假),研究与大脑其余部分刺激目标相关的EC变化,结果:在体素水平上,EC从左DLPFC输出到左顶叶下叶和左额上回,以及从左LTL输出到左眶额皮质,具有显著的组×时间交互效应。在网络层面,从边缘网络到默认模式网络,EC的增加产生了显著的交互作用。体素水平EC的降低和网络水平EC的增加都与日常生活活动能力和认知功能的提高有关。结论:多部位rTMS结合认知训练可以调节AD患者的有效连接,从而提高患者的日常生活能力和认知功能。
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来源期刊
CiteScore
6.00
自引率
5.70%
发文量
135
审稿时长
4-8 weeks
期刊介绍: Frontiers in Neural Circuits publishes rigorously peer-reviewed research on the emergent properties of neural circuits - the elementary modules of the brain. Specialty Chief Editors Takao K. Hensch and Edward Ruthazer at Harvard University and McGill University respectively, are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics and the public worldwide. Frontiers in Neural Circuits launched in 2011 with great success and remains a "central watering hole" for research in neural circuits, serving the community worldwide to share data, ideas and inspiration. Articles revealing the anatomy, physiology, development or function of any neural circuitry in any species (from sponges to humans) are welcome. Our common thread seeks the computational strategies used by different circuits to link their structure with function (perceptual, motor, or internal), the general rules by which they operate, and how their particular designs lead to the emergence of complex properties and behaviors. Submissions focused on synaptic, cellular and connectivity principles in neural microcircuits using multidisciplinary approaches, especially newer molecular, developmental and genetic tools, are encouraged. Studies with an evolutionary perspective to better understand how circuit design and capabilities evolved to produce progressively more complex properties and behaviors are especially welcome. The journal is further interested in research revealing how plasticity shapes the structural and functional architecture of neural circuits.
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