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Factors influencing the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of patients with Alzheimer's disease

Transcranial magnetic encephalopathy physiological therapy (rTMS) is a safe, non-invasive intervention technology that has achieved certain results in improving the cognitive function of patients with Alzheimer's disease (AD). The differences in efficacy of different rTMS treatment plans may be related to factors such as stimulation frequency, mode, site, maintenance time, intensity, and focusing ability. Research shows that high-frequency rTMS is more effective than low-frequency rTMS; indirect theta burst stimulation is as effective as traditional rTMS, but each treatment time is shorter and patient compliance is improved; stimulating damaged brain areas or related networks in AD patients can improve efficacy; short-term reinforcement Combining treatment with long-term maintenance treatment can maintain the therapeutic effect; dynamically adjusting the stimulation intensity according to the degree of cognitive impairment can improve the therapeutic effect; the focusing ability of rTMS can be solved through technologies such as magnetic resonance functional connection methods. This article analyzes the above influencing factors to provide ideas for the design of future clinical programs for rTMS treatment of AD.

AD is a neurodegenerative disease with insidious onset and progressive development. The main feature is early memory loss. As the disease progresses, additional impairments in two or more cognitive domains develop, such as executive function and attention. Strength, language, social cognition and judgment, psychomotor speed, visual operation or visuospatial ability seriously affect an individual's daily independence and quality of life, and bring heavy economic and psychological burdens to society and families.

Up to now, the research and development of new AD drugs have almost all ended in failure, and the use of traditional drugs has many limitations. Therefore, more and more researchers are beginning to explore non-drug treatments.

Transcranial magnetic encephalopathy physiological therapy (rTMS), as a non-drug treatment for AD, has achieved good results in improving the cognitive function and memory of AD patients. Previous studies have shown that rTMS with a frequency of 10~20 Hz and an intensity of 90%~120% rMT stimulates the DLPFC, precuneus, left parietal lobe and other brain areas of AD patients for 1~6 weeks, which can improve the cognitive function of AD patients. Knowledge function. And the drug effect can be maintained for a period of time; the efficacy of high frequency is better than that of low frequency, and the efficacy of rTMS at higher frequencies (such as 40 Hz) can be further explored; iTBS has the advantages of short treatment time and low cost, and the difference in efficacy between iTBS and rTMS can be Further research; the longer the stimulation, the longer lasting the effects. As rTMS treatment equipment gradually becomes available for home use, short-term intensive treatment combined with long-term maintenance treatment has broad prospects; the optimal stimulation intensity is related to the patient's cognitive function. In the future, the stimulation intensity can be dynamically adjusted according to changes in the degree of cognitive impairment of patients, and the focusing ability of rTMS can be solved based on technologies such as magnetic resonance functional connection methods to provide personalized and effective stimulation for AD brain areas or related networks that are damaged.

Due to differences in cerebral cortical activity, disease severity, clinical manifestations, comorbid physical diseases, genetics and other factors among different AD patients, the clinical efficacy varies significantly. Relevant factors should be comprehensively analyzed and established through information technology such as artificial intelligence. A model for implementing an individualized treatment plan. It is believed that with the continuous deepening of basic research and clinical application, rTMS will bring good news to AD patients.