Neural Regeneration Research ›› 2021, Vol. 16 ›› Issue (4): 707-713.doi: 10.4103/1673-5374.295345

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Neuroimaging mechanisms of high-frequency repetitive transcranial magnetic stimulation for treatment of amnestic mild cognitive impairment: a double-blind randomized sham-controlled trial

Li-Qiong Yuan1, #, Qing Zeng1, #, Dan Wang2, Xiu-Yun Wen2, Yu Shi1, Fen Zhu2, Shang-Jie Chen2, *, Guo-Zhi Huang1, 3, *#br#   

  1. 1 Department of Rehabilitation Medicine and Physiotherapy, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong Province, China;  2 Department of Rehabilitation Medicine and Physiotherapy, Shenzhen Baoan Hospital of Southern Medical University, Shenzhen, Guangdong Province, China;  3 Rehabilitation School of Southern Medical University, Guangzhou, Guangdong Province, China
  • Online:2021-04-15 Published:2020-12-21
  • Contact: Guo-Zhi Huang, PhD, drhuang66@163.com; Shang-Jie Chen, PhD, csjme@163.com.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, No. 81874032 (to GZH); the Science and Technology Planning Project of Shenzhen of China, No. JCYJ20160427191726109 (to FZ); the Science and Technology Planning Project of Guangdong Province of China, No. 2016A020215202 (to SHC); and Shenzhen Health and Family Planning System Research Project of China, No. SZXJ2017069 (to SHC).

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Abstract: Individuals with amnestic mild cognitive impairment (aMCI) have a high risk of developing Alzheimer’s disease. Although repetitive transcranial magnetic stimulation (rTMS) is considered a potentially effective treatment for cognitive impairment in patients with aMCI, the neuroimaging mechanisms are poorly understood. Therefore, we performed a double-blind randomized sham-controlled trial in which rTMS was applied to the left dorsolateral prefrontal cortex of aMCI patients recruited from a community near the Third Hospital Affiliated to Sun Yat-sen University, China. Twenty-four patients with aMCI were randomly assigned to receive true rTMS (treatment group, n = 12, 6 men and 6 women; age 65.08 ± 4.89 years) or sham stimulation (sham group, n = 12, 5 men and 7 women; age 64.67 ± 4.77 years). rTMS parameters included a stimulation frequency of 10 Hz, stimulation duration of 2 seconds, stimulation interval of 8 seconds, 20 repetitions at 80% of the motor threshold, and 400 pulses per session. rTMS/sham stimulation was performed five times per week over a period of 4 consecutive weeks. Our results showed that compared with baseline, Montreal Cognitive Assessment scores were significantly increased and the value of the amplitude of low-frequency fluctuation (ALFF) was significantly increased at the end of treatment and 1 month after treatment. Compared with the sham group, the ALFF values in the right inferior frontal gyrus, triangular part of the inferior frontal gyrus, right precuneus, left angular gyrus, and right supramarginal gyrus were significantly increased, and the ALFF values in the right superior frontal gyrus were significantly decreased in the treatment group. These findings suggest that high-frequency rTMS can effectively improve cognitive function in aMCI patients and alter spontaneous brain activity in cognitive-related brain areas. This study was approved by the Ethics Committee of Shenzhen Baoan Hospital of Southern Medical University, China (approval No. BYL20190901) on September 3, 2019 and registered in the Chinese Clinical Trials Registry (registration No. ChiCTR1900028180) on December 14, 2019.

Key words: Alzheimer’s disease, clinical trial, cognitive function, cognitive impairment, functional magnetic resonance imaging, neurological function, repetitive transcranial magnetic stimulation