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ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Alzheimer's Disease and Related Dementias
Volume 16 - 2024 |
doi: 10.3389/fnagi.2024.1460853
This article is part of the Research Topic A comprehensive look at biomarkers in neurodegenerative diseases: from early diagnosis to treatment response assessment View all 18 articles
Decreased Prefrontal Activation During Verbal Fluency Task After Repetitive Transcranial Magnetic Stimulation Treatment for Depression in Alzheimer's Disease: A Functional Near-Infrared Spectroscopy Study
Provisionally accepted
Yuanzhi Zhao
1,2
Conglong Qiu
1,2
Ping Lin
1,2
Mei Yang
1,2
Ling Huang
1,2
Zheng Zhao
1,2
Wu Xiangping
3*
Dongsheng Zhou
1*- 1 Affiliated Kangning Hospital of Ningbo University, Ningbo, Zhejiang Province, China
- 2 Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, Zhejiang Province, China
- 3 Ningbo Women and Children's Hospital, Ningbo, Zhejiang, China
Background: Studies have shown the clinical effects of repetitive transcranial magnetic stimulation (rTMS) on depression in Alzheimer's disease (AD). However, the underlying mechanisms remain poorly understood. The measurement of brain activation links neurobiological and functional aspects but is challenging in patients with dementia. This study investigated the influence of rTMS on cortical activation in patients with AD and depressive symptoms, measured using functional nearinfrared spectroscopy (fNIRS) during a verbal fluency task. Methods: In this randomized, doubleblind study, patients with AD and depression received either active rTMS (n = 17) or sham-rTMS (n = 16). Patients received 4 weeks of bilateral standard rTMS (1 Hz rTMS delivered to the right dorsolateral prefrontal cortex (DLPFC) and 10-Hz rTMS delivered to the left DLPFC). Results: No significant changes were found in the Mini-Mental State Examination (MMSE) and Modified Barthel Index (MBI); however, significant changes were found for the 17-item Hamilton Depression Rating Scale (HAMD-17) and the depression score of the Neuropsychiatric Inventory(NPIdepression)(p < 0.05). The results showed a decrease in the concentration of oxygenated hemoglobin, as measured with fNIRS, from baseline to week 4 in CH41 (in right DLPFC; p = 0.0047, FDRcorrected). There was a negative correlation between the improvement in HAMD-17 severity in these patients and reduced oxygenated hemodynamic response of CH41 (r = -0.504, p = 0.039). Conclusions: The results indicated a positive effect of rTMS on depression in patients with AD. The underlying cortical changes were imaged using fNIRS. Prefrontal activation measured by fNIRS is a potential biomarker for monitoring the response of patients with depression in AD to rTMS treatment.
Keywords: Depression in AD, repetitive transcranial magnetic stimulation, Prefrontal Cortex, functional near-infrared spectroscopy, verbal fluency task, bilateral standard rTMS
Received: 07 Jul 2024; Accepted: 24 Dec 2024.
Copyright: © 2024 Zhao, Qiu, Lin, Yang, Huang, Zhao, Xiangping and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wu Xiangping, Ningbo Women and Children's Hospital, Ningbo, 315012, Zhejiang, China
Dongsheng Zhou, Affiliated Kangning Hospital of Ningbo University, Ningbo, Zhejiang Province, China
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