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Intérêt de la stimulation magnétique transcrânienne dans la maladie d’Alzheimer

Cognitive effects of repetitive transcranial magnetic stimulation (rTMS) in Alzheimer disease

  • Article Original / Original Article
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Les cahiers de l'année gérontologique

Résumé

La maladie d’Alzheimer (MA) est la plus fréquente des formes de démences dégénératives. Il existe actuellement différentes pistes thérapeutiques dont les traitements médicamenteux spécifiques utilisés pour ralentir la progression de la maladie. Ces médicaments ont démontré un effet symptomatique sur certains symptômes cognitifs et non cognitifs de la MA à court terme, mais les effets sur l’amélioration des fonctions cognitives ne sont que limités. Dans ce contexte, d’autres méthodes thérapeutiques sont actuellement en cours d’étude. Parmi celles-ci, la stimulation magnétique transcrânienne répétée (rTMS) pourrait se révéler intéressante. En effet, le traitement par la rTMS de patients souffrants de dépression ou atteints de la maladie de Parkinson montre une capacité à améliorer certaines fonctions cognitives. Dans la MA, les études sont rares et centrées sur l’évaluation ciblée de certaines fonctions cognitives. À l’heure actuelle, deux études de Cotelli et al. ont montré un effet favorable de la rTMS haute fréquence délivrée au cortex préfrontal dorsolatéral (CPFDL) droit ou gauche de patients atteints de MA lors d’une tâche cognitive, à savoir une tâche de dénomination d’une image représentant une action ou un objet. Aucune étude ne s’est encore intéressée à l’effet de la rTMS à long terme. Les auteurs présentent la revue de la littérature sur l’impact cognitif de la rTMS en illustrant leurs propos avec les premiers résultats d’une étude évaluant l’effet de la technique sur la cognition des patients atteints de MA. La stimulation magnétique transcrânienne semble une piste thérapeutique prometteuse dans la prise en charge de cette pathologie.

Abstract

Alzheimer’s disease (AD) is the most common form of dementia. Specific medications have demonstrated a symptomatic effect on some cognitive and noncognitive symptoms, but these effects remain limited. In this context, other therapeutic fields have to be studied. Among those, repetitive transcranial magnetic stimulation (rTMS) could represent a new approach. Cognitive effects of rTMS in patients with depression and Parkinson’s disease have been reported. A few studies have dealt specifically with the effects of rTMS on the cognitive ability of AD patients. These studies highlighted a positive effect of high-frequency rTMS applied on the right or left dorsolateral prefrontal cortex in patients with probable AD during a naming task of an image representing an action or an object. We present a review of major cognitive effects of rTMS and report the effects of the use of this noninvasive procedure (rTMS) on the cognitive symptoms of an AD patient. To conclude, rTMS could be used as therapy, but a specific protocol for AD should be determined.

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Authors and Affiliations

  1. Service de psychiatrie de l’adulte, CHU de Besançon, 2, place Saint-Jacques, F-25030, Besançon cedex, France

    P. Vandel, G. Chopard, M. Nicolier, J. Monnin, D. Sechter & E. Haffen

  2. EA 481 Neurosciences, IFR 133, université de Franche-Comté, F-25030, Besançon cedex, France

    P. Vandel, G. Chopard, E. Magnin, J. Monnin, D. Sechter & E. Haffen

  3. Centre d’investigation clinique CIC-IT 808 Inserm, CHU de Besançon, F-25030, Besançon cedex, France

    J. Monnin, L. Pazart & E. Haffen

  4. Service de neurologie, CHU de Besançon, F-25030, Besançon cedex, France

    G. Chopard, E. Magnin, J. Galmiche & L. Rumbach

  5. Centre mémoire de ressources et de recherche, CHU de Besançon, F-25030, Besançon cedex, France

    P. Vandel, G. Chopard, E. Magnin, J. Galmiche & L. Rumbach

  6. Réseau RAPIDFR-NAT (Réseau d’aide au diagnostic, à la prise en charge des détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et au niveau national), F-25000, Besançon, France

    P. Vandel, G. Chopard, J. Galmiche & L. Rumbach

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  1. P. Vandel
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  2. G. Chopard
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  3. E. Magnin
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  4. M. Nicolier
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  10. E. Haffen
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Correspondence to P. Vandel.

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Vandel, P., Chopard, G., Magnin, E. et al. Intérêt de la stimulation magnétique transcrânienne dans la maladie d’Alzheimer. cah. année gerontol. 3, 131–135 (2011). https://doi.org/10.1007/s12612-011-0191-4

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  • DOI: https://doi.org/10.1007/s12612-011-0191-4

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