scholarly journals Cognitive effects and acceptability of non-invasive brain stimulation on Alzheimer’s disease and mild cognitive impairment: a component network meta-analysis

2020 ◽  
pp. jnnp-2020-323870 ◽  
Author(s):  
Che-Sheng Chu ◽  
Cheng-Ta Li ◽  
Andre R. Brunoni ◽  
Fu-Chi Yang ◽  
Ping-Tao Tseng ◽  
...  

ObjectivesTo compare cognitive effects and acceptability of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in patients with Alzheimer’s disease (AD) or mild cognitive impairment (MCI), and to determine whether cognitive training (CT) during rTMS or tDCS provides additional benefits.MethodsElectronic search of PubMed, Medline, Embase, the Cochrane Library and PsycINFO up to 5 March 2020. We enrolled double-blind, randomised controlled trials (RCTs). The primary outcomes were acceptability and pre–post treatment changes in general cognition measured by Mini-Mental State Examination, and the secondary outcomes were memory function, verbal fluency, working memory and executive function. Durability of cognitive benefits (1, 2 and ≥3 months) after brain stimulation was examined.ResultsWe included 27 RCTs (n=1070), and the treatment components included high-frequency rTMS (HFrTMS) and low-frequency rTMS, anodal tDCS (atDCS) and cathodal tDCS (ctDCS), CT, sham CT and sham brain stimulation. Risk of bias of evidence in each domain was low (range: 0%–11.1%). HFrTMS (1.08, 9, 0.35–1.80) and atDCS (0.56, 0.03–1.09) had short-term positive effects on general cognition. CT might be associated with negative effects on general cognition (−0.79, –2.06 to 0.48) during rTMS or tDCS. At 1-month follow-up, HFrTMS (1.65, 0.77–2.54) and ctDCS (2.57, 0.20–4.95) exhibited larger therapeutic responses. Separate analysis of populations with pure AD and MCI revealed positive effects only in individuals with AD. rTMS and tDCS were well tolerated.ConclusionsHFrTMS is more effective than atDCS for improving global cognition, and patients with AD may have better responses to rTMS and tDCS than MCI.

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 60
Author(s):  
Ioannis Mavroudis ◽  
Rumana Chowdhury ◽  
Foivos Petridis ◽  
Eleni Karantali ◽  
Symela Chatzikonstantinou ◽  
...  

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder, associated with extensive neuronal loss, dendritic and synaptic changes resulting in significant cognitive impairment. An increased number of studies have given rise to the neuroinflammatory hypothesis in AD. It is widely accepted that AD brains show chronic inflammation, probably triggered by the presence of insoluble amyloid beta deposits and neurofibrillary tangles (NFT) and is also related to the activation of neuronal death cascade. In the present study we aimed to investigate the role of YKL-40 levels in the cerebrospinal fluid (CSF) in the diagnosis of AD, and to discuss whether there are further potential roles of this protein in the management and treatment of AD. We conducted an online search on PubMed, Web of Science, and the Cochrane library databases from 1990 to 2021. The quantitative analysis showed that the levels of YKL-40 were significantly higher in Alzheimer’s disease compared to controls, to mild cognitive impairment (MCI) AD (MCI-AD) and to stable MCI. They were also increased in MCI-AD compared to stable MCI. The present study shows that the CSF levels of YKL-40 could be potentially used as a biomarker for the prognosis of mild cognitive impairment and the likelihood of progression to AD, as well as for the differential diagnosis between AD and MCI.


2021 ◽  
Vol 13 ◽  
Author(s):  
Huanhuan Liu ◽  
Dandan Zhang ◽  
Huawei Lin ◽  
Qi Zhang ◽  
Ling Zheng ◽  
...  

The changes of neurochemicals in mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients has been observed via magnetic resonance spectroscopy in several studies. However, whether it exists the consistent pattern of changes of neurochemicals in the encephalic region during the progression of MCI to AD were still not clear. The study performed meta-analysis to investigate the patterns of neurochemical changes in the encephalic region in the progress of AD. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases, and finally included 63 studies comprising 1,086 MCI patients, 1,256 AD patients, and 1,907 healthy controls. It showed that during the progression from MCI to AD, N-acetyl aspartate (NAA) decreased continuously in the posterior cingulate (PC) (SMD: −0.42 [95% CI: −0.62 to −0.21], z = −3.89, P < 0.05), NAA/Cr (creatine) was consistently reduced in PC (SMD: −0.58 [95% CI: −0.86 to −0.30], z = −4.06, P < 0.05) and hippocampus (SMD: −0.65 [95% CI: −1.11 to −0.12], z = −2.44, P < 0.05), while myo-inositol (mI) (SMD: 0.44 [95% CI: 0.26–0.61], z = 4.97, P < 0.05) and mI/Cr (SMD: 0.43 [95% CI: 0.17–0.68], z = 3.30, P < 0.05) were raised in PC. Furthermore, these results were further verified by a sustained decrease in the NAA/mI of PC (SMD: −0.94 [95% CI: −1.24 to −0.65], z = −6.26, P < 0.05). Therefore, the levels of NAA and mI were associated with the cognitive decline and might be used as potentially biomarkers to predict the possible progression from MCI to AD.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020200308.


2011 ◽  
Vol 5 (2) ◽  
pp. 64-68 ◽  
Author(s):  
Lívia Spíndola ◽  
Sonia Maria Dozzi Brucki

Abstract Prospective memory (PM) is defined as remembering to carry out intended actions at an appropriate point in the future, and can be categorized into three types of situation: time-, event-, and activity-based tasks. PM involves brain structures such as frontal and medial temporal cortices. The aim of this study was to review the currently available literature on PM in Alzheimer's disease and Mild Cognitive Impairment patients. We performed a search on Pubmed, Medline, ScieLO, LILACS and the Cochrane Library electronic databases from January 1990 to December 2010. The key terms used were: prospective memory, memory for intentions, delayed memory and memory for future actions, separately and also combined with the search terms dementia, Alzheimer's disease and Mild Cognitive Impairment. Both patient groups showed significant impairment in PM. Further studies are needed to verify the accuracy of PM tasks as an early marker of mild cognitive impairment, and initial dementia.


2017 ◽  
Vol 25 (2) ◽  
pp. 67-79 ◽  
Author(s):  
Maria Cotelli ◽  
Rosa Manenti ◽  
Michela Brambilla ◽  
Elena Gobbi ◽  
Clarissa Ferrari ◽  
...  

Introduction Given the limited effectiveness of pharmacological treatments, non-pharmacological interventions in neurodegenerative diseases have gained increasing attention in recent years and telerehabilitation has been proposed as a cognitive rehabilitation strategy. The purpose of this systematic review is to examine the evidence for the efficacy of cognitive telerehabilitation interventions compared with face-to-face rehabilitation in patients with mild cognitive impairment, Alzheimer’s disease and frontotemporal dementia. Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of the Medline database was conducted. Out of 14 articles assessed for eligibility, five studies were identified, three in participants with mild cognitive impairment or Alzheimer’s disease, two in patients with primary progressive aphasia. Results The Physiotherapy Evidence Database scale was used to assess the methodological quality of four out of five studies included in this systematic review, with only one report receiving a high-quality rating. Effect-size analysis evidenced positive effects of telerehabilitation interventions, comparable with those reported for face-to-face rehabilitation. Discussion The available evidence for the effectiveness of cognitive telerehabilitation is limited, and the quality of the evidence needs to be improved. The systematic review provides preliminary evidence suggesting that cognitive telerehabilitation for neurodegenerative disease may have comparable effects as conventional in-person cognitive rehabilitation.


2018 ◽  
Vol 31 (04) ◽  
pp. 491-504 ◽  
Author(s):  
Tiago C. C. Pinto ◽  
Leonardo Machado ◽  
Tatiana M. Bulgacov ◽  
Antônio L. Rodrigues-Júnior ◽  
Maria L. G. Costa ◽  
...  

ABSTRACTObjective:To compare the accuracy of Mini-Mental State Examination (MMSE) and of the Montreal Cognitive Assessment (MoCA) in tracking mild cognitive impairment (MCI) and Alzheimer’s Disease (AD).Method:A Systematic review of the PubMed, Bireme, Science Direct, Cochrane Library, and PsycInfo databases was conducted. Using inclusion and exclusion criteria and staring with 1,629 articles, 34 articles were selected. The quality of the selected research was evaluated through the Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2).Result:More than 80% of the articles showed MoCA to be superior to MMSE in discriminating between individuals with mild cognitive impairment and no cognitive impairment. The area under the curve varied from 0.71 to 0.99 for MoCA, and 0.43 to 0.94 for MMSE, when evaluating the ability to discriminate MCI in the cognitively healthy elderly individuals, and 0.87 to 0.99 and 0.67 to 0.99, respectively, when evaluating the detection of AD. The AUC mean value for MoCA was significantly larger compared to the MMSE in discriminating MCI from control [0.883 (CI 95% 0.855-0.912) vs MMSE 0.780 (CI 95% 0.740-0.820) p < 0.001].Conclusion:The screening tool MoCA is superior to MMSE in the identification of MCI, and both tests were found to be accurate in the detection of AD.


2021 ◽  
Author(s):  
Xiaodong Chen ◽  
Yunfeng Luo

Abstract Background Serum ghrelin levels have been reported to be altered in Alzheimer’s disease (AD) patients and individuals with Mild cognitive impairment (MCI). However, whether serum ghrelin can be used as a biomarker of AD is inconsistent and conflicting. Methods We carried out a systematic review and meta-analysis to examine the serum levels of ghrelin and acylated ghrelin (AG) in patients with AD or MCI, in comparison with normal controls (NC). We searched PubMed, The Cochrane Library, Web of Science and Chinese National Knowledge Infrastructure (CNKI) from 1999 to March 2021. Results 10 relevant studies were included for this study. 8 studies reported serum levels of ghrelin (417 AD or MCI patients and 382 controls) and 5 studies reported serum levels of AG (142 AD or MCI patients and 152 controls). We found that AD and MCI patients had a tendency toward a decrease in the serum levels of ghrelin (SMD=-1.04; 95%CI (-2.30, 0.23); P = 0.11; significant heterogeneity: I2 = 98%), but no statistical significance was found. AG levels in the serum level of AD and MCI patients were significantly higher than NC subjects (SMD = 0.99; 95%CI (0.21, 1.77); P = 0.01; significant heterogeneity: I2 = 87%). Conclusion This meta-analysis suggested that AG may be a potential MCI or early AD biomarker and confirmed previous findings that ghrelin became desensitized in AD patients. This meta-analysis was limited to small sample sizes and lacked of stratifying the level of heterogeneity in AD and MCI patients. More and large sample, multi-center case-control studies on the relationship between serum AG and AD or MCI patients are still needed in the future.


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