| Objective: The use of non-invasive brain stimulation(NIBS)methods for the treatment of Alzheimer’s disease(AD)has received much attention in recent years.Both transcranial direct current stimulation(t DCS)and transcranial alternating current stimulation(t ACS)have some online effects on improving cognition in AD patients,but the offline effects are insufficient.In our trial,we will explore the online effects of t DCS and t ACS on improving cognition in AD patients,and use t ACS combined with sound stimulation to treat AD patients,and explore the safety and efficacy of t ACS combined with sound stimulation,as well as the online and offline effects on the cognitive function of AD patients.Method: A total of 22 patients with AD were enrolled in this trial,and all AD patients will be divided into three groups.Received 15 sessions of t DCS treatment,40Hz-t ACS treatment,or 40Hz-t ACS combined with sound stimulation.10 patients with AD were assigned to t DCS group or sham-t DCS group in a randomized,double-blind,sham controls.For patients with mild to moderate AD,changes in Alzheimer’s Disease Assessment Scale-Cognitive(ADAS-Cog)scores was used as the primary evaluation of efficacy.Changes in scores of other scales such as Clinical Dementia Graded Score(CDR),Mental State Examination Scale(MMSE),Montreal Cognitive Assessment(Mo CA)was used as secondary indicators of efficacy.For patients with severe AD,changes in Neuropsychiatric Inventory(NPI)scores was used as the primary measure of efficacy.Results: Of the 10 patients with AD who received t DCS.In the t DCS group,3 of those showed a decrease in ADAS-Cog scores after treatment and 2patients showed a small increase in ADAS-Cog scores.However,in the sham-t DCS group,none of the 5 patients showed any reduction in their ADAS-Cog scores after treatment.In the 5 patients with mild to moderate AD after the application of 40 Hz-t ACS treatment,the mean ADAS-Cog score decreased by 3points compared to the score at baseline,but at the 3-month follow-up,the mean ADAS-Cog score increased by 4 points compared to the score at baseline.There was no statistically significant difference in the comparison of score changes pre-and post-treatment between the t DCS group and the t ACS group of patients with mild to moderate AD(P=0.678 > 0.05).In the 5 patients with severe AD after the application of 40 Hz-t ACS treatment,there was only a slight improvement in the cognitive scale scores,but the mean NPI scale score decreased by 12.4 points.In patients with mild to moderate AD who applied 40Hz-t ACS in combination with sound stimulation,the ADAS-Cog score was improved consistently after treatment and at follow-up.This phenomenon was not seen in patients with mild to moderate AD treated with t ACS.Conclusion: t DCS or 40 Hz-t ACS has a online-effect on improving cognition in patients with mild to moderate AD;40 Hz-t ACS has an effect on improving psychoneurological symptoms in patients with severe AD;40Hz-t ACS combined with sound stimulation may have a long-term after-effect on improving cognition in patients with mild to moderate AD.However,due to insufficient sample size,the study results have certain limitations,and a larger sample is needed for further verification. |
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