Journal: Frontiers in Neurology (2021)
Authors: Leocani L, Dalla Costa G, Coppi E, Santangelo R, Pisa M, Ferrari L, Bernasconi MP, Falautano M, Zangen A, Magnani G, Comi G
Background:
Focal rTMS has been applied to improve cognition in Alzheimer’s disease (AD) with conflicting results. H Coils are suitable for targeting wider neuronal structures compared with first-generation Figure-8 coils. In particular, the H2 Coil stimulates simultaneously the frontal-parietal-temporal lobes bilaterally.
Objective:
Evaluate H2 Coil Deep TMS in AD in a pilot placebo-controlled study.
Methods:
Thirty patients (mean age 70.9 year, SD 8.1; mean MMSE score 16.9, SD 5.5) were randomized to sham or real 10 Hz H2 Coil Deep TMS. Each patient underwent 3 sessions/week for 4 weeks, followed by 4 weeks with maintenance treatment (1 session/week). Primary outcome was improvement of ADAS-cog at 4 and 8 weeks compared with baseline.
Results:
A trend toward an improved ADAS-cog score over time was observed for patients undergoing real Deep TMS, with actively treated patients experiencing a mean decrease of −1.01 points at the ADAS-Cog scale score per time point (95% CIs −0.02 to −3.13, p < 0.04). This trend was no longer evident 2 months after the end of treatment. Real Deep TMS showed no significant effect on MMSE and BDI changes over time.
Conclusions:
These preliminary findings suggest that H2 Coil Deep TMS is feasible and safe in patients with probable AD and might provide beneficial, though transient, effects on cognition. This study prompts larger studies in the early stages of AD, combining Deep TMS and cognitive rehabilitation.
