title: Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly: A Randomized Controlled Study.
abstract: Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique with potential to improve memory. Mild cognitive impairment (MCI), which still lacks a specific therapy, is a clinical syndrome associated with increased risk of dementia. This study aims to assess the effects of high-frequency repetitive TMS (HF rTMS) on everyday memory of the elderly with MCI. We conducted a double-blinded randomized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex (DLPFC). Thirty-four elderly outpatients meeting Petersen's MCI criteria were randomly assigned to receive 10 sessions of either active TMS or sham, 10 Hz rTMS at 110% of motor threshold, 2,000 pulses per session. Neuropsychological assessment at baseline, after the last session (10th) and at one-month follow-up, was applied. ANOVA on the primary efficacy measure, the Rivermead Behavioural Memory Test, revealed a significant group-by-time interaction (p = 0.05), favoring the active group. The improvement was kept after one month. Other neuropsychological tests were heterogeneous. rTMS at 10 Hz enhanced everyday memory in elderly with MCI after 10 sessions. These findings suggest that rTMS might be effective as a therapy for MCI and probably a tool to delay deterioration.
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Hellen Livia
authors.initials: HL
authors.lastname: Drumond Marra
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Martin Luiz
authors.initials: ML
authors.lastname: Myczkowski
authors.affiliation: Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Maia Memória
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Débora
authors.initials: D
authors.lastname: Arnaut
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Philip
authors.initials: P
authors.lastname: Leite Ribeiro
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Carlos Gustavo
authors.initials: CG
authors.lastname: Sardinha Mansur
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Lancelote Alberto
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Bianca
authors.initials: B
authors.lastname: Boura Bellini
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Adriano
authors.initials: A
authors.lastname: Alves Fernandes da Silva
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Tortella
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil ; Division of Neurological Surgery, Pain Center, Department of Neurology, University of São Paulo, Avenida Dr. Enéas de Carvalho Aguiar 255, Sala 5084, Cerqueira César, 05403-900 São Paulo, SP, Brazil.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ciampi de Andrade
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil ; Division of Neurological Surgery, Pain Center, Department of Neurology, University of São Paulo, Avenida Dr. Enéas de Carvalho Aguiar 255, Sala 5084, Cerqueira César, 05403-900 São Paulo, SP, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil.
authors.forename: Orestes Vicente
authors.initials: OV
authors.lastname: Forlenza
authors.affiliation: Transcranial Magnetic Stimulation Laboratory, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovidio Pires de Campos 785, 05402-010 São Paulo, SP, Brazil ; Division of Neurological Surgery, Pain Center, Department of Neurology, University of São Paulo, Avenida Dr. Enéas de Carvalho Aguiar 255, Sala 5084, Cerqueira César, 05403-900 São Paulo, SP, Brazil.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Marcolin
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000503:physiopathology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods; D016896:Treatment Outcome