ObjectiveImpaired interhemispheric connectivity and corpus callosum atrophy have been linked to cognitive impairment in Alzheimer's disease (AD). Existing evidence indicates that repetitive transcranial magnetic stimulation (rTMS) targeting the bilateral precuneus may enhance cognitive function in AD. This study aims to investigate the effects of precuneus rTMS on cognitive function, as well as alterations in interhemispheric functional connectivity (FC) and its structural basis in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI).MethodsA total of 14 patients with SCD and 16 patients with MCI were enrolled in this study and received 10 Hz rTMS intervention on the bilateral precuneus for 2 weeks. Neurocognitive scales, structural and functional magnetic resonance imaging were collected at enrollment and after the rTMS intervention. Interhemispheric FC was assessed using mirror homotopic functional connectivity (VMHC), while the structural equation modeling (SEM) was employed to analyze the relationship between corpus callosum volume, interhemispheric connectivity, and cognitive function after rTMS intervention.ResultsThe precuneus rTMS not only enhanced episodic memory in SCD, but also improved multiple cognitive domains in MCI. Post-rTMS intervention, decreased VMHC values in the lingual cortex, middle occipital gyrus, putamen, and fusiform gyrus were observed in SCD, and an increased VMHC value in the postcentral gyrus along with reduced VMHC value in the cerebellum and putamen in MCI. After intervention, more brain regions show decreased FC in SCD and MCI patients, suggesting that precuneus rTMS may protect cerebral cortical plasticity by reducing excessive functional compensation, and thus improve cognitive function. The SEM indicated that the corpus callosum serves as the structural foundation for rTMS regulation of interhemispheric FC to further improve cognitive function.Conclusion10 Hz rTMS in the bilateral precuneus could be a promising strategy to improve cognitive function in patients with SCD and MCI. Our study implies that improvements in cognition brought about by precuneus rTMS may result from the remodeling of interhemispheric FC, with the corpus callosum possibly acting as the anatomical basis for functional modulation.
基金：
This study was supported by Clinical Research Special Funded Project of Nanjing Drum Tower Hospital (No. 2023-LCYJ-MS-11), Special Funded Project of Nanjing Drum Tower Hospital (No. RC2022-023), Development Plan (Social Development) Project of Jiangsu Province (No. BE2022679), Natural Science Foundation of Jiangsu Basic Research Program (No. BK20221185).
第一作者机构：[1]Nanjing Med Univ, Dept Neurosurg, Affiliated Brain Hosp, Nanjing, Jiangsu, Peoples R China
共同第一作者：
通讯作者：
通讯机构：[1]Nanjing Med Univ, Dept Neurosurg, Affiliated Brain Hosp, Nanjing, Jiangsu, Peoples R China[5]Nanjing Univ, Nanjing Drum Tower Hosp, Affiliated Hosp Med Sch, Dept Radiol, Nanjing, Peoples R China
推荐引用方式(GB/T 7714)：
Ge Honglin,Chen Shanshan,Che Zigang,et al.rTMS regulates homotopic functional connectivity in the SCD and MCI patients[J].FRONTIERS IN NEUROSCIENCE.2023,17:doi:10.3389/fnins.2023.1301926.
APA：
Ge, Honglin,Chen, Shanshan,Che, Zigang,Wu, Huimin,Yang, Xinyi...&Chen, Jiu.(2023).rTMS regulates homotopic functional connectivity in the SCD and MCI patients.FRONTIERS IN NEUROSCIENCE,17,
MLA：
Ge, Honglin,et al."rTMS regulates homotopic functional connectivity in the SCD and MCI patients".FRONTIERS IN NEUROSCIENCE 17.(2023)
医学