The Influence Of Repetitive Transcranial Magnetic Stimulation On Regulation And Cognitive Functions Of Patients With Alzheimer’s Disease

Objectives: To verify whether high frequency repetitive transcranial magnetic stimulation(r TMS) impact the cognitive function of Alzheimer’s disease patients(AD)or not. With imaging technique of the resting state functional magnetic resonance imaging(f MRI), to observe changes of brain function network of r TMS treatment pre-AD and post-AD and to explore how r TMS modulate AD brain network.Methods: Collect 30 cases of mild and moderate patients who meet the diagnostic criteria for the AD group in which was divided into the treated group(n=15 patients) and the control group(n=15 patients) by random, Both groups received r TMS treatment with same parameter and treating time(5seconds, 5s), interval of 25 s, 100% motor threshold(MT), and 50 pulses, every day with 30 sequences and receiving continuous 10-days treatment. But the control group took false stimulation treatment. All patients received Neuropsychological scale assessment before treatment and two weeks after treatment,including mini-mental state examination(MMSE) and Alzheimer’s disease assessment scale disease assessment scale cognition(ADAS-cog) and activity daily living(ADL)、neuropsychiatric inventory questionnaire(NPI)、Boston Naming Test(BNT)、Digit Span Test(DST). At same time, f MRI data are extracted from all patients with 3.0 T MRI. Date analysis are performed in order to obtain f MRI brain network of two groups with short-range functional connectivity density mapping( LFCD), Selecting different areas of the brainas a seed point of pre treatment and post treatment of patients. Have the changes of function connection of AD based on the region of interest(ROI) functional connection methods.Second, observe the transformation of functional network connectivity(FNC)based on independent component analysis(ICA). Datum are analyzed by SPSS19.0 and T sample Test、Pared Test and Chi-square test. The measurement data is expressed by X ±S.Results:(1)Clinical results: According to the results of f MRI, ultimately 12 cases selected in treatment group and control group 10 patients were analyzed. Two groups of patients before treatment MMSE, NPI, ADAS- cog, ADL, BNT, DST scale comparison difference has no statistical significance(P > 0.05). Treatment group after treatment for 2 weeks before the scale to assess the treatment were improved, the difference was statistically significant(all P < 0.05). Compared with control group, Treatment group on the MMSE, NPI, BNT, ADAS- cog scale assessment have different degrees of improvement, the difference was statistically significant(all P < 0.05).(2)FMRI function connection research results: Control group have no function change on LFCD after treatment.Compared with before treatment, treated group found on the LFCD of left precuneus(precuneus- L) increased after treatment. As the seed point connection analysis: with precuneus-L as the seed point, the increased function connection brain regions are in the right inferior parietal lobule,bilateral supplementary motor area and left paracentral lobule, the reduced functional connectivity is in the left putamen. FNC:Compared with the before treatment,AD patients after treatment showed significantly increased FNCs between central executive network and salience network(CEN-SN), between default-mode network and salience network(DMN-SN),and between sensorimotor network and default-mode network(SMN-DMN), between central executive network and cerebellum network(CEN-CERE).(3)No discomfort was found for patients in the whole treatment.Conclusion:(1)As for AD patients with left DLPFC who receive intervention therapy, Patients’ cognitive function has been improved, which involved in emotion, attention control, linguistic function. Along with these, there is a tendency that related scale’s item has been bettered. Thus, the results verify that r TMS affect the cure treatment of AD patients.(2)10Hz r TMS treatment has no risk.(3)The mechanism of r TMS improve cognition behavior of patients with L-DLPFC: On the one hand, it is based on integration of the cognitive and sport network integration, adjusting the coordination between the movement and cognitive function and improve cognitive network. On the other hand, it may modulate the default network involved and be associated with cognitive function related to the functional connection between network neuroimaging.