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

Abstract

Cortical excitability can be modulated using repetitive transcranial magnetic stimulation (rTMS). Previously, we showed that rTMS combined with cognitive training (rTMS-COG) has positive results in Alzheimer’s disease (AD). The goal of this randomized double-blind, controlled study was to examine the safety and efficacy of rTMS-COG in AD. Fifteen AD patients received 1-h daily rTMS-COG or sham treatment (seven treated, eight placebo), five sessions/week for 6 weeks, followed by biweekly sessions for 3 months. The primary outcome was improvement of the cognitive score. The secondary outcome included improvement in the Clinical Global Impression of Change (CGIC) and Neuropsychiatric Inventory (NPI). There was an improvement in the average ADAS-cog score of 3.76 points after 6 weeks in the treatment group compared to 0.47 in the placebo group and 3.52 points after 4.5 months of treatment, compared to worsening of 0.38 in the placebo (P = 0.04 and P = 0.05, respectively). There was also an improvement in the average CGIC score of 3.57 (after 6 weeks) and 3.67 points (after 4.5 months), compared to 4.25 and 4.29 in the placebo group (mild worsening) (P = 0.05 and P = 0.05, respectively). NPI improved non-significantly. In summary, the NeuroAD system offers a novel, safe and effective therapy for improving cognitive function in AD.

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Acknowledgments

We thank Dr. Ariela Alter (Neuronix Ltd., Yokneam, Israel) for her contribution to the manuscript and Dr. Innesa Bekerman for performing the MRI anatomical determinations.

Conflict of interest

Neuronix Ltd, Yokneam, Israel financially supported this study through The Fund for Medical Research, Development of Infrastructure and Health Services––Assaf Harofeh Medical Center, Israel. The study sponsors supported the study by providing funds. The design, the collection, analysis and interpretation of the data, the writing of the report and the decision to submit the paper were the entire responsibility of the corresponding author and the co-authors. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. Prof. Rabey (the corresponding author) is a consultant for Neuronix Ltd.

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Correspondence to Jose M. Rabey.

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Rabey, J.M., Dobronevsky, E., Aichenbaum, S. 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 120, 813–819 (2013). https://doi.org/10.1007/s00702-012-0902-z

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Keywords

  • rTMS
  • Alzheimer’s disease
  • Cognitive training
  • ADAS-cog