rTMS as a Treatment of Alzheimer’s Disease with and without Comorbidity of Depression: A Review

Table 1

Comparison of rTMS protocols for treatment of Alzheimer’s disease.

Paper title	Number of participants	Depression	Participant age (Mean ± SD)	Level of dementia (AD)	Stimulation site	Frequency	Intensity	Length of trial
Effect of transcranial magnetic stimulation on action naming in patients With Alzheimer's disease [9]	15	Excluded	76.6±6	Mild-moderate cognitive decline, probable AD	Right and left DLPFC, sham	20 Hz	90%
Transcranial magnetic stimulation improves naming in Alzheimer's disease patients at different stages of cognitive decline [10]	24	Excluded	Moderate-severe AD: 77.6 ± 5.8; Mild AD: 75 ± 6.2	12 moderate-severe AD, 12 mild AD	Right and left DLPFC, sham	20 Hz	90%
Improved language performance in Alzheimer's disease following brain stimulation [11]	10 (5 real-real stimulation,; 5 placebo-real stimulation)	Excluded	74.4 ± 3.8	Probable moderate AD	Left DLPFC	20 Hz	100%	2 weeks (5/week) real or placebo, followed by 2 weeks all real
Beneficial effect of repetitive transcranial magnetic stimulation combined with cognitive training for the treatment of Alzheimer’s disease: a proof of concept study [13]	8	6/8 had history of depression	75.4 ± 4.4	Probable early-moderate AD (Clinical Dementia Rating of 1)	6 regions (3 per day, every other day); (i) Broca, Wernicke and right DLPFC; (ii) left DLPFC and right and left parietal somatosensory association cortex (pSAC)	10 Hz	90% for Broca and DLPFC, 110% for Wernicke and pSAC	6 weeks (5/week), followed by maintenance (2/week) for 3 months
Effects of low versus high frequencies of repetitive transcranial magnetic stimulation and functional excitability in Alzheimer’s dementia [12]	45 (15 HF stimulation, 15 LF stimulation, 15 sham stimulation)	Depression not excluded. Assessment of patient depression improved with rTMS.	68.4; (SD not specified)	32 probable mild-moderate AD, 13 probable severe AD	Right and left DLPFC (right, then left hemisphere consecutively stimulated)	HF: 20 Hz; LF: 1 Hz	HF: 90%; LF: 100%	5 days