scholarly journals Vascular Cognitive Impairment through the Looking Glass of Transcranial Magnetic Stimulation

2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
Giuseppe Lanza ◽  
Placido Bramanti ◽  
Mariagiovanna Cantone ◽  
Manuela Pennisi ◽  
Giovanni Pennisi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Transcranial Magnetic Stimulation ◽  
Neural Plasticity ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Disease Process ◽  
Vascular Cognitive Impairment ◽  
Vascular Lesions ◽  
Early Markers ◽  
Degenerative Dementia

In the last years, there has been a significant growth in the literature exploiting transcranial magnetic stimulation (TMS) with the aim at gaining further insights into the electrophysiological and neurochemical basis underlying vascular cognitive impairment (VCI). Overall, TMS points at enhanced brain cortical excitability and synaptic plasticity in VCI, especially in patients with overt dementia, and neurophysiological changes seem to correlate with disease process and progress. These findings have been interpreted as part of a glutamate-mediated compensatory effect in response to vascular lesions. Although a single TMS parameter owns low specificity, a panel of measures can support the VCI diagnosis, predict progression, and possibly identify early markers of “brain at risk” for future dementia, thus making VCI a potentially preventable cause of both vascular and degenerative dementia in late life. Moreover, TMS can be also exploited to select and evaluate the responders to specific drugs, as well as to become an innovative rehabilitative tool in the attempt to restore impaired neural plasticity. The present review provides a perspective of the different TMS techniques by further understanding the cortical electrophysiology and the role of distinctive neurotransmission pathways and networks involved in the pathogenesis and pathophysiology of VCI and its subtypes.

scholarly journals Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation

2020 ◽  
Vol 2020 ◽  
pp. 1-17
Author(s):  
Mariagiovanna Cantone ◽  
Giuseppe Lanza ◽  
Francesco Fisicaro ◽  
Manuela Pennisi ◽  
Rita Bella ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Synaptic Plasticity ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Disease Process ◽  
Vascular Cognitive Impairment ◽  
Future Research ◽  
Disease Modifying Drugs

The exact relationship between cognitive functioning, cortical excitability, and synaptic plasticity in dementia is not completely understood. Vascular cognitive impairment (VCI) is deemed to be the most common cognitive disorder in the elderly since it encompasses any degree of vascular-based cognitive decline. In different cognitive disorders, including VCI, transcranial magnetic stimulation (TMS) can be exploited as a noninvasive tool able to evaluate in vivo the cortical excitability, the propension to undergo neural plastic phenomena, and the underlying transmission pathways. Overall, TMS in VCI revealed enhanced cortical excitability and synaptic plasticity that seem to correlate with the disease process and progression. In some patients, such plasticity may be considered as an adaptive response to disease progression, thus allowing the preservation of motor programming and execution. Recent findings also point out the possibility to employ TMS to predict cognitive deterioration in the so-called “brains at risk” for dementia, which may be those patients who benefit more of disease-modifying drugs and rehabilitative or neuromodulatory approaches, such as those based on repetitive TMS (rTMS). Finally, TMS can be exploited to select the responders to specific drugs in the attempt to maximize the response and to restore maladaptive plasticity. While no single TMS index owns enough specificity, a panel of TMS-derived measures can support VCI diagnosis and identify early markers of progression into dementia. This work reviews all TMS and rTMS studies on VCI. The aim is to evaluate how cortical excitability, plasticity, and connectivity interact in the pathophysiology of the impairment and to provide a translational perspective towards novel treatments of these patients. Current pitfalls and limitations of both studies and techniques are also discussed, together with possible solutions and future research agenda.

scholarly journals Update on the Neurobiology of Vascular Cognitive Impairment: From Lab to Clinic

2020 ◽  
Vol 21 (8) ◽  
pp. 2977 ◽  
Author(s):  
Luisa Vinciguerra ◽  
Giuseppe Lanza ◽  
Valentina Puglisi ◽  
Francesco Fisicaro ◽  
Manuela Pennisi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Disease Process ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Cognitive Disorder ◽  
Vascular Lesion ◽  
Adaptive Plasticity ◽  
Disease Modifying Drugs ◽  
Neurophysiological Studies ◽  
Degenerative Dementia

In the last years, there has been a significant growth in the literature exploring the pathophysiology of vascular cognitive impairment (VCI). As an “umbrella term” encompassing any degree of vascular-related cognitive decline, VCI is deemed to be the most common cognitive disorder in the elderly, with a significant impact on social and healthcare expenses. Interestingly, some of the molecular, biochemical, and electrophysiological abnormalities detected in VCI seem to correlate with disease process and progression, eventually promoting an adaptive plasticity in some patients and a maladaptive, dysfunctional response in others. However, the exact relationships between vascular lesion, cognition, and neuroplasticity are not completely understood. Recent findings point out also the possibility to identify a panel of markers able to predict cognitive deterioration in the so-called “brain at risk” for vascular or mixed dementia. This will be of pivotal importance when designing trials of disease-modifying drugs or non-pharmacological approaches, including non-invasive neuromodulatory techniques. Taken together, these advances could make VCI a potentially preventable cause of both vascular and degenerative dementia in late life. This review provides a timely update on the recent serological, cerebrospinal fluid, histopathological, imaging, and neurophysiological studies on this “cutting-edge” topic, including the limitations, future perspectives and translational implications in the diagnosis and management of VCI patients.

scholarly journals Assessment of Cortical Plasticity in Schizophrenia by Transcranial Magnetic Stimulation

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Turki Abualait ◽  
Sultan Alzahrani ◽  
Ahmed AlOthman ◽  
Fahad Abdulah Alhargan ◽  
Nouf Altwaijri ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Neural Plasticity ◽  
Magnetic Stimulation ◽  
Cortical Plasticity ◽  
Cortical Excitability ◽  
Molecular Genetic ◽  
Cortical Networks ◽  
Noninvasive Brain Stimulation ◽  
Pathophysiological Mechanisms ◽  
Cortical Dysfunction

Neural plasticity refers to the capability of the brain to modify its structure and/or function and organization in response to a changing environment. Evidence shows that disruption of neuronal plasticity and altered functional connectivity between distinct brain networks contribute significantly to the pathophysiological mechanisms of schizophrenia. Transcranial magnetic stimulation has emerged as a noninvasive brain stimulation tool that can be utilized to investigate cortical excitability with the aim of probing neural plasticity mechanisms. In particular, in pathological disorders, such as schizophrenia, cortical dysfunction, such as an aberrant excitatory-inhibitory balance in cortical networks, altered cortical connectivity, and impairment of critical period timing are very important to be studied using different TMS paradigms. Studying such neurophysiological characteristics and plastic changes would help in elucidating different aspects of the pathophysiological mechanisms underlying schizophrenia. This review attempts to summarize the findings of available TMS studies with diagnostic and characterization aims, but not with therapeutic purposes, in schizophrenia. Findings provide further evidence of aberrant excitatory-inhibitory balance in cortical networks, mediated by neurotransmitter pathways such as the glutamate and GABA systems. Future studies with combining techniques, for instance, TMS with brain imaging or molecular genetic typing, would shed light on the characteristics and predictors of schizophrenia.

scholarly journals Transcranial magnetic stimulation therapeutic applications on sleep and insomnia: a review

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ricardo Oroz ◽  
Simon Kung ◽  
Paul E. Croarkin ◽  
Joseph Cheung
Keyword(s):  
Clinical Trials ◽  
Major Depressive Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Neural Plasticity ◽  
Magnetic Stimulation ◽  
Randomized Clinical Trials ◽  
Cortical Excitability ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Major Depressive

AbstractRepetitive transcranial magnetic stimulation (rTMS) is a neuromodulatory technique approved by the US Food and Drug Administration for use in treatment-resistant major depressive disorder. It works by generating localized magnetic fields that create depolarizing electrical currents in neurons a few centimeters below the scalp. This localized effect is believed to stimulate neural plasticity, activate compensatory processes, and influence cortical excitability. Additionally, rTMS has been used in a variety of clinical trials for neurological and psychiatric conditions such as anxiety, post-traumatic stress disorder and epilepsy. Beneficial effects in sleep parameters have been documented in these trials, as well as in major depressive disorder, and have led to an interest in using rTMS in the field of sleep medicine for specific disorders such as insomnia, hypersomnia, and restless legs syndrome. It is unknown whether rTMS has intrinsically beneficial properties when applied to primary sleep disorders, or if it only acts on sleep through mood disorders. This narrative review sought to examine available literature regarding the application of rTMS for sleep disorder to identify knowledge gaps and inform future study design. The literature in this area remains scarce, with few randomized clinical trials on rTMS and insomnia. Available studies have found mixed results, with some studies reporting subjective sleep improvement while objective improvement is less consistent. Due to the heterogeneity of results and the variations in rTMS protocols, no definitive conclusions have been reached, signaling the need for further research.

scholarly journals Cognitive Improvement Via Left Angular Gyrus-Navigated Repetitive Transcranial Magnetic Stimulation Inducing the Neuroplasticity of Thalamic System in Alzheimer’s Disease Spectrum Patients

2021 ◽  
Author(s):  
Zhiyuan Yang ◽  
Xiaoning Sheng ◽  
Ruomeng Qin ◽  
Haifeng Chen ◽  
Pengfei Shao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Diffusion Tensor ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Disease Process ◽  
Functional Network ◽  
Angular Gyrus ◽  
Cognitive Improvement ◽  
Left Angular Gyrus

Abstract Background: Stimulating superficial brain regions highly associated with the hippocampus by repetitive transcranial magnetic stimulation (rTMS) may improve memory of Alzheimer disease (AD) spectrum patients. Methods: We recruited 26 mild cognitive impairment (MCI) and AD patients. All the patients were stimulated to the left angular gyrus, which was confirmed a strong link to the hippocampus through neuroimaging studies, by the neuro-navigated rTMS for four weeks. Automated fiber quantification (AFQ) using diffusion tensor imaging (DTI) metrics and graph theory analysis on functional network were employed to detect the neuroplasticity of brain networks. Results: After neuro-navigated rTMS intervention, the episodic memory and language function of patients were significantly improved. Increased white matter integrity of right anterior thalamic radiation among MCI patients, while decreased functional network properties of thalamus subregions were observed. It is worth noting that the improvement of cognition was associated with the neuroplasticity of thalamic systemConclusions: We speculated that the rTMS intervention targeting left angular gyrus may be served as a strategy to improve cognitive impairment in AD spectrum patients, supporting by the neuroplasticity of thalamic system, especially in the early disease process at the stage of MCI.

Abstract #80: Assessment of cortical excitability with Transcranial Magnetic Stimulation in patients with brain tumor

2019 ◽  
Vol 12 (2) ◽  
pp. e28
Author(s):  
Cintya Hayashi ◽  
Iuri S. Nevile ◽  
Cesar C. Almeida ◽  
Priscila Rodrigues ◽  
Ricardo RG. Galhardoni ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Cortical Excitability

scholarly journals Transcranial Magnetic Stimulation as a Tool to Investigate Motor Cortex Excitability in Sport

2021 ◽  
Vol 11 (4) ◽  
pp. 432
Author(s):  
Fiorenzo Moscatelli ◽  
Antonietta Messina ◽  
Anna Valenzano ◽  
Vincenzo Monda ◽  
Monica Salerno ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Cortex ◽  
Magnetic Stimulation ◽  
Motor Coordination ◽  
Cortical Excitability ◽  
Non Invasive ◽  
Motor Cortex Excitability ◽  
Invasive Method ◽  
And Control ◽  
The Impact

Transcranial magnetic stimulation, since its introduction in 1985, has brought important innovations to the study of cortical excitability as it is a non-invasive method and, therefore, can be used both in healthy and sick subjects. Since the introduction of this cortical stimulation technique, it has been possible to deepen the neurophysiological aspects of motor activation and control. In this narrative review, we want to provide a brief overview regarding TMS as a tool to investigate changes in cortex excitability in athletes and highlight how this tool can be used to investigate the acute and chronic responses of the motor cortex in sport science. The parameters that could be used for the evaluation of cortical excitability and the relative relationship with motor coordination and muscle fatigue, will be also analyzed. Repetitive physical training is generally considered as a principal strategy for acquiring a motor skill, and this process can elicit cortical motor representational changes referred to as use-dependent plasticity. In training settings, physical practice combined with the observation of target movements can enhance cortical excitability and facilitate the process of learning. The data to date suggest that TMS is a valid technique to investigate the changes in motor cortex excitability in trained and untrained subjects. Recently, interest in the possible ergogenic effect of non-invasive brain stimulation in sport is growing and therefore in the future it could be useful to conduct new experiments to evaluate the impact on learning and motor performance of these techniques.

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