title: Chronic treatment with rivastigmine in patients with Alzheimer's disease: a study on primary motor cortex excitability tested by 5 Hz-repetitive transcranial magnetic stimulation.
abstract: OBJECTIVE
  To investigate changes in cortical excitability and short-term synaptic plasticity we delivered 5 Hz repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex in 11 patients with mild-to-moderate Alzheimer's disease (AD) before and after chronic therapy with rivastigmine.
  
  
  METHODS
  Resting motor threshold (RMT), motor evoked potential (MEP), cortical silent period (CSP) after single stimulus and MEP facilitation during rTMS trains were tested three times during treatment. All patients underwent neuropsychological tests before and after receiving rivastigmine. rTMS data in patients were compared with those from age-matched healthy controls.
  
  
  RESULTS
  At baseline, RMT was significantly lower in patients than in controls whereas CSP duration and single MEP amplitude were similar in both groups. In patients, rTMS failed to induce the normal MEP facilitation during the trains. Chronic rivastigmine intake significantly increased MEP amplitude after a single stimulus, whereas it left the other neurophysiological variables studied unchanged. No significant correlation was found between patients' neuropsychological test scores and TMS measures.
  
  
  CONCLUSIONS
  Chronic treatment with rivastigmine has no influence on altered cortical excitability and short-term synaptic plasticity as tested by 5 Hz-rTMS.
  
  
  CONCLUSIONS
  The limited clinical benefits related to cholinesterase inhibitor therapy in patients with AD depend on factors other than improved plasticity within the cortical glutamatergic circuits.
authors: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors: A
authors: A
authors: Trebbastoni
authors: F
authors: F
authors: Gilio
authors: F
authors: F
authors: D'Antonio
authors: C
authors: C
authors: Cambieri
authors: M
authors: M
authors: Ceccanti
authors: C
authors: C
authors: de Lena
authors: M
authors: M
authors: Inghilleri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D000704:Analysis of Variance; D016022:Case-Control Studies; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000187:drug effects*; D005260:Female; D007839:Functional Laterality / Q000187:drug effects; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D009044:Motor Cortex / Q000187:drug effects*; D018482:Muscle, Skeletal / Q000187:drug effects; D018696:Neuroprotective Agents / Q000494:pharmacology / Q000627:therapeutic use; D048448:Phenylcarbamates / Q000494:pharmacology* / Q000627:therapeutic use*; D011930:Reaction Time; D000068836:Rivastigmine; D050781:Transcranial Magnetic Stimulation
chemical_list: D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000068836:Rivastigmine