Role of repetitive transcranial magnetic stimulation in management of alzheimer's disease

• Main Authors: Hrishikesh B Nachane, Jahnavi S Kedare
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Annals of Indian Psychiatry
• Subjects: alzheimer's disease; cognition; repetitive transcranial magnetic stimulation
• Online Access: http://www.anip.co.in/article.asp?issn=2588-8358;year=2020;volume=4;issue=2;spage=122;epage=125;aulast=Nachane

Management strategies in Alzheimer's disease (AD) are challenging and limited in several aspects. Repetitive transcranial magnetic stimulation (rTMS), being a noninvasive brain stimulation method, has recently been studied in the management of AD. The literature available is different on several aspects such as patient enrollment, site of stimulation, outcome measures, and follow-up. We present a narrative review highlighting important aspects of rTMS in AD. We searched the databases of Google Scholar and PubMed using the search terms: rTMS and Alzheimer's disease; rTMS and cognition; rTMS and dementia; and brain stimulation and Alzheimer's disease. Original research, case reports and series, other narrative reviews, systematic reviews, and meta-analyses were included, and studies where only abstracts were available were excluded. Majority of the studies present a modest benefit of rTMS in mild–moderate AD and some in normal aging and mild cognitive impairment. Improvement is marked in high-frequency rTMS as compared to low frequency. The favorite site of stimulation appears to be the dorsolateral prefrontal cortex (DLPFC). Studies chiefly assessed cognitive function, while sparingly involving other areas of impairment such as psychopathology and global functioning. Improvement in cognition is mainly in the weeks ensuring rTMS, and studies assessing improvement in a long-term follow-up are needed. There appears to be minimal to no side effects reported in most studies. Future implications of rTMS in AD are suggested.