title: Improved language performance in Alzheimer disease following brain stimulation.
abstract: OBJECTIVE
  Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a possible treatment for the cognitive deficits associated with Alzheimer disease (AD). The aim of this study was to assess the long-term effects, on cognitive performance, of rTMS applied to the left dorsolateral prefrontal cortex (DLPFC) in AD patients.
  
  
  METHODS
  Ten AD patients were randomly assigned to one of two study groups. Multiple-baseline design was used.The first group underwent a 4-week real rTMS stimulation protocol, while the second underwent a 2-week placebo treatment, followed by 2 weeks of real rTMS stimulation. Each session consisted of the application of rhythmic high-frequency rTMS over the DLPFC for 25 min. Sessions occurred once daily, 5 days/week. The main analysed outcome was the change in cognitive test performance at 2 and 4 weeks after rTMS treatment initiation, with a follow-up performed 8 weeks after the end of rTMS, in comparison with baseline performance.
  
  
  RESULTS
  A significant difference was found between groups over sessions in terms of the percentage of correct responses of auditory sentence comprehension. Only real treatment induced an improvement in performance with respect to baseline or placebo. Moreover, both groups showed a lasting effect on the improved performance 8 weeks after the end of treatment.
  
  
  CONCLUSIONS
  The findings provide initial evidence for the persistent beneficial effects of rTMS on sentence comprehension in AD patients. Rhythmic rTMS, in conjunction with other therapeutic interventions, may represent a novel approach to the treatment of language dysfunction in AD patients.
authors.affiliation: IRCCS Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia 25125, Italy. mcotelli@fatebenefratelli.it
authors.forename: Maria
authors.initials: M
authors.lastname: Cotelli
authors.forename: Marco
authors.initials: M
authors.lastname: Calabria
authors.forename: Rosa
authors.initials: R
authors.lastname: Manenti
authors.forename: Sandra
authors.initials: S
authors.lastname: Rosini
authors.forename: Orazio
authors.initials: O
authors.lastname: Zanetti
authors.forename: Stefano F
authors.initials: SF
authors.lastname: Cappa
authors.forename: Carlo
authors.initials: C
authors.lastname: Miniussi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000523:psychology* / Q000628:therapy*; D001037:Aphasia / Q000523:psychology; D001519:Behavior; D003071:Cognition / Q000502:physiology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007802:Language; D008297:Male; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000503:physiopathology; D011597:Psychomotor Performance / Q000502:physiology; D012959:Socioeconomic Factors; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome