P2‐019: Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training in Alzheimer’s Disease

Repetitive transcranial magnetic stimulation (rTMS) has been examined as a potential treatment for many neurological disorders. High-frequency rTMS in particular improves cognitive functions such as verbal fluency and memory. In previous study, we reported that rTMS combined with cognitive training (rTMS-COG) showed cognitive improvement with Alzheimer’s disease (AD), especially, in mild group. We investigated the long-term effect of rTMS-COG and did the follow-up treatment with same patients. A prospective, randomized, double-blind, placebo-controlled study was performed with 27 AD patients (18 and 8 in the treatment and sham groups, respectively, and 1 dropout) in previous study. After 2 years, 8 patients of the 26 patients, who wanted to retreat the rTMS-COG, repeated the rTMS-COG treat without sham treatment. The rTMS protocols were configured for six cortical areas (both dorsolateral prefrontal and parietal somatosensory associated cortices and Broca’s and Wernicke’s areas; 10 Hz, 90–110% intensity, and 5 days/week for 6 weeks). Neuropsychological assessments were performed using the AD Assessment Scale-cognitive subscale (ADAS-cog), Clinical Global Impression of Change (CGIC), and MMSE before and immediately after the end of rTMS-COG treatment. There was no significant interactive effect of time between the groups at first treatment, although ADAS-cog score in treatment group (from 23.6 at baseline to 18.2 at the end of the study) was much more improved than sham group (from 22.9 at baseline to 20.0 at the end of the study). At the second rTMS-COG treatment, the 8 patients showed significant improvement compared to baseline score (ADAS-cog changed from 22.9 to 23.4, p=0.038). The present study suggests that rTMS-COG has effect on cognition and could be helpful in patients with Alzheimer’s disease.