Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive treatment approved by the U.S. Food and Drug Administration for the treatment of clinical depression. The therapy is also being studied as a potential treatment for Alzheimer's disease.
How
rTMS works
Alzheimer's disease is the most common cause of dementia, affecting millions of people around the world, mostly older adults. In these people, synaptic activity (the connections between nerve cells) breaks down and brain networks gradually falter, leading to a decline in memory and the ability to think and learn.
rTMS is a procedure that stimulates and modulates the nervous system. Doctors place a device on the patient's scalp that sends electromagnetic pulses to specific areas of the brain.
Although exactly how the technology works is unclear, researchers believe the magnetic fields create electrical currents within the brain that affect the activity of nerve cells, stimulating them and helping improve symptoms of Alzheimer's disease.
rTMS in clinical trials
A clinical trial in 10 Alzheimer's disease patients evaluated the effectiveness of targeted rTMS on expressive language.
Participants were randomly assigned to one of two groups. One group received rTMS treatment and the other received a placebo. Results from the trial, published in the Journal of Neurology, Neurosurgery & Psychiatry, showed that the treatment group showed significant improvements in understanding correct responses to spoken sentences compared with placebo or before treatment.
A proof-of-concept study was also conducted to verify the effects of daily rTMS combined with cognitive training (tasks prepared by neuropsychologists targeting specific brain regions) in eight patients with Alzheimer's disease.
The trial results, published in the Journal of Neurotransmission, showed that rTMS improved thinking skills (as measured by ADAS-cog scores), a test used to measure cognitive abilities in people with Alzheimer's disease.
The same researchers conducted a randomized phase 1 study to explore long-term improvements in overall thinking skills in 15 Alzheimer's disease patients after receiving rTMS and cognitive training. They confirmed that the treatment significantly improved patients' ADAS-cog scores compared with the placebo group. The findings were published in the Journal of Neurotransmission.
The potential of rTMS as a treatment for Alzheimer's disease and to improve sleep quality was also evaluated in a two-phase pilot study .
Phase 1 was a double-blind crossover study with 13 real and sham treatments over 4 weeks; Phase 2 was an open-label study with 10 sessions of the same treatment as follow-up.
Study results showed greater improvements across all assessments, including Montreal Cognitive Assessment (MOCA) scores, a brief 30-question test that detects cognitive impairment, and ADAS-cog scores. The findings were published in the Journal of Experimental Neuroscience.
