Application of repetitive transcranial magnetic
stimulation combined with cognitive learning for the
treatment of Alzheimer’s disease: a pilot study
Jose M Rabey, MD,1 Eugenia Dobronevsky, MD,1 Sergio Aichenbaum,
MD,1 Ran Shorer, PhD,2 Ruth Peretz, PhD2 and Michael Haigrecht, MD2
Department of Neurology, and Memory Clinic, Assaf Harofeh Medical Center,
Zerifin, affiliated to Sackler School of Medicine, Tel Aviv University, Israel
Objective: This is a pioneer study in which we have applied repetitive
transcranial magnetic stimulation (rTMS) combined with cognitive
training (CgT) for the treatment of Alzheimer’s disease (AD) patients.
Background: TMS is a technique for noninvasive painless brain
stimulation. It generates a small electric current in the brain that induces, if applied repetitively (rTMS), a modulation in brain cortical
excitability. rTMS has been explored as a potential novel therapeutic tool for different neuropsychiatric conditions.
Patients and Methods: Eight AD patients, (DSM-IVR), MMSE of
18 to 24, were subjected to 30 daily sessions (45 minutes duration
each; 6 weeks), followed by bi-weekly maintenance sessions for 3
more months, of rTMS while simultaneously performing CgT tasks,
using the Neuronix® system. Six cortical brain regions (selected in
each patient by brain MRI), were stimulated. CgT was specifically
developed according to the regions stimulated. Treatment effects
were assessed using: ADAS Cog, ADAS ADL, MMSE and CGI.
Results: ADAS-cog results showed average improvements of -4.2
points after 6 weeks and -4.0 points after 4.5 months (p<0.01 and
p<0.05 respectively). CGI also show positive results. ADAS ADL
and MMSE did not change. No side effects were reported, and patient participation remained high throughout the entire study.
Conclusions: We conclude that based on current results, the Neuronix® system seems to offer a promising technique for the treatment of cognitive functions in AD, at least as good as current
available drugs. A double blind, European multinational study is
currently under way