title: Non-invasive brain stimulation of the right inferior frontal gyrus may improve attention in early Alzheimer's disease: a pilot study.
abstract: BACKGROUND
  Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive tool for modulating cortical activity.
  
  
  OBJECTIVE
  In this pilot study, we evaluated the effects of high frequency rTMS applied over the right inferior frontal gyrus (IFG) on cognitive functions in patients with amnestic mild cognitive impairment (MCI) or incipient dementia due to Alzheimer's disease (AD).
  
  
  METHODS
  Ten patients (6 men; 4 women, mean age of 72 ± 8 years; MMSE 23 ± 3.56) were enrolled in a randomized, placebo-controlled study with a crossover design. All participants received 2 sessions of 10 Hz rTMS over the non-dominant right hemisphere in random order: IFG (active stimulation site) and vertex (control stimulation site). Intensities were adjusted to 90% of resting motor threshold. A total of 2250 pulses were applied in a session. The Trail Making Test (TMT), the Stroop test, and the complex visual scene encoding task (CVSET) were administered before and immediately after each session. The Wilcoxon paired test was used for data analysis.
  
  
  RESULTS
  Stimulation applied over the IFG induced improvement in the TMT parts A (p = 0.037) and B (p = 0.049). No significant changes were found in the Stroop test or the CVSET after the IFG stimulation. We observed no significant cognitive aftereffects of rTMS applied over the vertex.
  
  
  CONCLUSIONS
  High frequency rTMS of the right IFG induced significant improvement of attention and psychomotor speed in patients with MCI/mild dementia due to AD. This pilot study is part of a more complex protocol and ongoing research.
authors.affiliation: First Department of Neurology, St. Anne's University Hospital, School of Medicine, Masaryk University, Brno, Czech Republic; Brain and Mind Research Program, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic.
authors.forename: Ilona
authors.initials: I
authors.lastname: Eliasova
authors.affiliation: First Department of Neurology, St. Anne's University Hospital, School of Medicine, Masaryk University, Brno, Czech Republic; Brain and Mind Research Program, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic.
authors.forename: Lubomira
authors.initials: L
authors.lastname: Anderkova
authors.affiliation: First Department of Neurology, St. Anne's University Hospital, School of Medicine, Masaryk University, Brno, Czech Republic; Brain and Mind Research Program, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic.
authors.forename: Radek
authors.initials: R
authors.lastname: Marecek
authors.affiliation: First Department of Neurology, St. Anne's University Hospital, School of Medicine, Masaryk University, Brno, Czech Republic; Brain and Mind Research Program, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic. Electronic address: irena.rektorova@fnusa.cz.
authors.forename: Irena
authors.initials: I
authors.lastname: Rektorova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology / Q000628:therapy*; D001288:Attention / Q000502:physiology*; D003071:Cognition / Q000502:physiology; D018592:Cross-Over Studies; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Alzheimer's disease; Attention; Inferior frontal gyrus; MCI; Noninvasive brain stimulation; rTMS