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Effects of Intermittent Theta Burst Stimulation on the Clock Drawing Test Performances in Patients with Alzheimer’s Disease
Brain Topography ( IF 2.7 ) Pub Date : 2021-04-08 , DOI: 10.1007/s10548-021-00836-2
Stefan Golaszewski 1, 2 , Alexander Kunz 1, 2 , Kerstin Schwenker 1, 2 , Luca Sebastianelli 3, 4 , Viviana Versace 3, 4 , Davide Ferrazzoli 3, 4 , Leopold Saltuari 3, 4 , Eugen Trinka 1, 2, 5, 6 , Raffaele Nardone 1, 2, 7
Affiliation  

The clock drawing test (CDT) is widely used in clinical neuropsychological practice. However, its neuroanatomical correlates have not been well established. This study investigated the effects of theta burst stimulation (TBS) applied over different brain regions on CDT scores in patients with Alzheimer’s disease (AD). The 10–20 positions F3, F4, T3, T4, TP3, TP4, P3, P4, as determined by a 10–20 positioning cap, were targeted. Excitatory intermittent TBS (iTBS) was given over the above-mentioned eight regions to ten AD patients and ten control subjects on separate days. CDT was administered at baseline (T0), during the 5 min following the TBS (T1) and 60 min after TBS (T2), with an inter-session interval of at least 4 days. iTBS over TP4 and P4 transiently increased Rouleau CDT score in AD patients. When targeting TP4 and P4, mainly the area of the supramarginal/angular gyrus and the inferior parietal lobe, corresponding respectively to the Brodmann areas 40/39 and 7/40, are reached. iTBS thus seems able to modulate activity of the right posterior parietal cortex in AD patients performing the CDT. Our results provide physiological evidence that those parietal regions are functionally important for the execution of the Rouleau CDT. This finding suggests that CDT has reliable neuroanatomical correlates, and support the notion that this test can be used as a good marker of right parietal brain dysfunction. The present study also highlights the therapeutic potential of the induction of neuromodulatory effects using non-invasive brain stimulation techniques.



中文翻译:

间歇性Theta爆发刺激对阿尔茨海默氏病患者钟表测试性能的影响

时钟绘图测试(CDT)在临床神经心理学实践中被广泛使用。但是,其神经解剖学相关性尚未得到很好的建立。这项研究调查了阿尔茨海默氏病(AD)患者在不同大脑区域应用theta爆发刺激(TBS)对CDT评分的影响。以10-20定位帽确定的10-20位置F3,F4,T3,T4,TP3,TP4,P3,P4为目标。在上述8个区域分别在10天中对10名AD患者和10名对照受试者进行了兴奋性间歇性TBS(iTBS)。在TBS之后的5分钟内(T1)和TBS之后的60分钟内(T2),在基线(T0)进行CDT,疗程间隔至少为4天。相对于TP4和P4的iTBS短暂增加了AD患者的Rouleau CDT评分。定位到TP4和P4时,主要到达分别对应于布罗德曼区域40/39和7/40的上颌/角回和顶顶下叶的区域。因此,iTBS在执行CDT的AD患者中似乎能够调节右后顶叶皮层的活性。我们的结果提供了生理证据,表明这些壁区对于Rouleau CDT的执行在功能上很重要。这一发现表明CDT具有可靠的神经解剖学相关性,并支持该测试可以用作右顶脑功能障碍的良好标志的观点。本研究还强调了使用非侵入性脑刺激技术诱导神经调节作用的治疗潜力。分别对应于Brodmann区域40/39和7/40。因此,iTBS在执行CDT的AD患者中似乎能够调节右后顶叶皮层的活性。我们的结果提供了生理证据,表明这些壁区对于Rouleau CDT的执行在功能上很重要。这一发现表明CDT具有可靠的神经解剖学相关性,并支持该测试可以用作右顶脑功能障碍的良好标志的观点。本研究还强调了使用非侵入性脑刺激技术诱导神经调节作用的治疗潜力。分别对应于Brodmann区域40/39和7/40。因此,iTBS在执行CDT的AD患者中似乎能够调节右后顶叶皮层的活性。我们的结果提供了生理证据,表明这些壁区对于Rouleau CDT的执行在功能上很重要。这一发现表明CDT具有可靠的神经解剖学相关性,并支持该测试可以用作右顶脑功能障碍的良好标志的观点。本研究还强调了使用非侵入性脑刺激技术诱导神经调节作用的治疗潜力。我们的结果提供了生理证据,表明这些壁区对于Rouleau CDT的执行在功能上很重要。这一发现表明CDT具有可靠的神经解剖学相关性,并支持该测试可以用作右顶脑功能障碍的良好标志的观点。本研究还强调了使用非侵入性脑刺激技术诱导神经调节作用的治疗潜力。我们的结果提供了生理证据,表明这些壁区对于Rouleau CDT的执行在功能上很重要。这一发现表明CDT具有可靠的神经解剖学相关性,并支持该测试可以用作右顶脑功能障碍的良好标志的观点。本研究还强调了使用非侵入性脑刺激技术诱导神经调节作用的治疗潜力。

更新日期:2021-04-08
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