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Behavioural Neurology
Volume 2017 (2017), Article ID 1421326, 16 pages
https://doi.org/10.1155/2017/1421326
Review Article

Vascular Cognitive Impairment through the Looking Glass of Transcranial Magnetic Stimulation

1Department 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
2I.R.C.C.S. Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy
3Spinal Unit, Emergency Hospital “Cannizzaro”, 829 Via Messina, 95126 Catania, Italy
4Department of Surgery and Medical-Surgical Specialties, University of Catania, 78 Via S. Sofia, 95123 Catania, Italy
5Department of Medical and Surgical Sciences and Advanced Technology, Section of Neurosciences, University of Catania, 78 Via S. Sofia, 95123 Catania, Italy

Correspondence should be addressed to Giuseppe Lanza; ti.ne.isao@aznalg

Received 18 November 2016; Revised 30 January 2017; Accepted 5 February 2017; Published 26 February 2017

Academic Editor: Raj Kalaria

Copyright © 2017 Giuseppe Lanza et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.