FROM NEUROSCIENCE LABORATORY TO NEUROLOGY CLINIC

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TRANSCRANIAL MAGNETIC STIMULATION APPLICATIONS IN ALZHEIMER’S DISEASE

Halil Aziz Velioğlu1,2

1Center for Psychiatric Neuroscience, Feinstein Institutes for Medical Research, Manhasset, NY, USA

2İstanbul Medipol University, Department of Neuroscience, İstanbul, Türkiye

Velioğlu HA. Transcranial Magnetic Stimulation Applications in Alzheimer’s Disease. In: Hanoğlu L, editor. From Neuroscience Laboratory to Neurology Clinic. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.5969.

ABSTRACT

Transcranial Magnetic Stimulation (TMS) is a noninvasive neurophysiological technique that has emerged as a promising treatment for Alzheimer’s disease (AD), offering potential benefits in enhancing cognitive functions, memory, and language abilities. TMS operates by delivering targeted magnetic pulses to the brain, inducing electrical currents in the cortex, which can modulate neural circuits associated with cognitive and behavioral functions. While TMS holds therapeutic promise, patient responses vary widely, emphasizing the need to understand factors influencing treatment efficacy. Advanced techniques, such as neuroimaging and machine learning, are being utilized to personalize TMS protocols, aiming to improve outcomes by tailoring stimulation to each patient’s neural profile.

Research on TMS in AD has explored various stimulation frequencies, target areas, and protocols. Repetitive TMS (rTMS) applied to regions such as the dorsolateral prefrontal cortex (DLPFC), Broca’s area, and Wernicke’s area has shown effectiveness in addressing language impairments and enhancing cognitive functions, including memory and executive abilities. Innovations such as intermittent thetaburst stimulation (iTBS) have further optimized TMS protocols, providing shorter, efficient treatment sessions that enhance cortical excitability and plasticity. Combining TMS with other therapeutic modalities, such as pharmacological interventions, transcranial direct current stimulation (tDCS), or cognitive training, has demonstrated synergistic effects, potentially extending and sustaining cognitive improvements.

Challenges persist, including the need to understand and enhance response variability and to sustain TMS effects over time. Future directions focus on refining TMS with advanced neuroimaging and datadriven methods, enabling clinicians to predict TMS responders and optimize protocols. The integration of TMS within comprehensive care strategies for AD may shift TMS from an adjunctive treatment to a core therapeutic option, offering new hope for slowing cognitive decline and improving quality of life for patients and their families. Through continued innovation, TMS holds significant potential to become a transformative approach in the treatment of Alzheimer’s disease.

Keywords: Transcranial magnetic stimulation; Alzheimer’s disease; Cognitive enhancement; Personalized neurostimulation; Neuroplasticity

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