title: Vascular Cognitive Impairment through the Looking Glass of Transcranial Magnetic Stimulation.
abstract: 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.
authors.affiliation: Department of Neurology IC, I.R.C.C.S. "Oasi" Institute for Research on Mental Retardation and Brain Aging, 73 Via Conte Ruggero, 94018 Troina, Italy.
authors.forename: Giuseppe
authors.identifier: 0000-0002-5659-662X
authors.initials: G
authors.lastname: Lanza
authors.affiliation: I.R.C.C.S. Centro Neurolesi "Bonino-Pulejo", Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy.
authors.forename: Placido
authors.identifier: 0000-0003-0394-8166
authors.initials: P
authors.lastname: Bramanti
authors.affiliation: Department of Neurology IC, I.R.C.C.S. "Oasi" Institute for Research on Mental Retardation and Brain Aging, 73 Via Conte Ruggero, 94018 Troina, Italy.
authors.forename: Mariagiovanna
authors.identifier: 0000-0002-9072-4971
authors.initials: M
authors.lastname: Cantone
authors.affiliation: Spinal Unit, Emergency Hospital "Cannizzaro", 829 Via Messina, 95126 Catania, Italy.
authors.forename: Manuela
authors.identifier: 0000-0003-0776-1411
authors.initials: M
authors.lastname: Pennisi
authors.affiliation: Department of Surgery and Medical-Surgical Specialties, University of Catania, 78 Via S. Sofia, 95123 Catania, Italy.
authors.forename: Giovanni
authors.identifier: 0000-0002-0911-2370
authors.initials: G
authors.lastname: Pennisi
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technology, Section of Neurosciences, University of Catania, 78 Via S. Sofia, 95123 Catania, Italy.
authors.forename: Rita
authors.identifier: 0000-0001-8332-6863
authors.initials: R
authors.lastname: Bella
mesh_terms: D000544:Alzheimer Disease / Q000503:physiopathology; D000818:Animals; D001921:Brain / Q000503:physiopathology; D003072:Cognition Disorders; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000503:physiopathology*; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D009473:Neuronal Plasticity; D050781:Transcranial Magnetic Stimulation / Q000379:methods*