Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation
The exact relationship between cognitive functioning, cortical excitability, and synaptic plasticity in dementia is not completely understood. Vascular cognitive impairment (VCI) is deemed to be the most common cognitive disorder in the elderly since it encompasses any degree of vascular-based cogni...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Neural Plasticity |
| Online Access: | http://dx.doi.org/10.1155/2020/8820881 |
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| author | Mariagiovanna Cantone Giuseppe Lanza Francesco Fisicaro Manuela Pennisi Rita Bella Vincenzo Di Lazzaro Giovanni Di Pino |
| author_facet | Mariagiovanna Cantone Giuseppe Lanza Francesco Fisicaro Manuela Pennisi Rita Bella Vincenzo Di Lazzaro Giovanni Di Pino |
| author_sort | Mariagiovanna Cantone |
| collection | DOAJ |
| description | The exact relationship between cognitive functioning, cortical excitability, and synaptic plasticity in dementia is not completely understood. Vascular cognitive impairment (VCI) is deemed to be the most common cognitive disorder in the elderly since it encompasses any degree of vascular-based cognitive decline. In different cognitive disorders, including VCI, transcranial magnetic stimulation (TMS) can be exploited as a noninvasive tool able to evaluate in vivo the cortical excitability, the propension to undergo neural plastic phenomena, and the underlying transmission pathways. Overall, TMS in VCI revealed enhanced cortical excitability and synaptic plasticity that seem to correlate with the disease process and progression. In some patients, such plasticity may be considered as an adaptive response to disease progression, thus allowing the preservation of motor programming and execution. Recent findings also point out the possibility to employ TMS to predict cognitive deterioration in the so-called “brains at risk” for dementia, which may be those patients who benefit more of disease-modifying drugs and rehabilitative or neuromodulatory approaches, such as those based on repetitive TMS (rTMS). Finally, TMS can be exploited to select the responders to specific drugs in the attempt to maximize the response and to restore maladaptive plasticity. While no single TMS index owns enough specificity, a panel of TMS-derived measures can support VCI diagnosis and identify early markers of progression into dementia. This work reviews all TMS and rTMS studies on VCI. The aim is to evaluate how cortical excitability, plasticity, and connectivity interact in the pathophysiology of the impairment and to provide a translational perspective towards novel treatments of these patients. Current pitfalls and limitations of both studies and techniques are also discussed, together with possible solutions and future research agenda. |
| format | Article |
| id | doaj-art-7acc157e16fc45779d425cdb040c011a |
| institution | Kabale University |
| issn | 2090-5904 1687-5443 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Neural Plasticity |
| spelling | doaj-art-7acc157e16fc45779d425cdb040c011a2025-08-20T03:35:02ZengWileyNeural Plasticity2090-59041687-54432020-01-01202010.1155/2020/88208818820881Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic StimulationMariagiovanna Cantone0Giuseppe Lanza1Francesco Fisicaro2Manuela Pennisi3Rita Bella4Vincenzo Di Lazzaro5Giovanni Di Pino6Department of Neurology, Sant’Elia Hospital, ASP Caltanissetta, Caltanissetta 93100, ItalyDepartment of Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, ItalyDepartment of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, ItalyDepartment of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania 95123, ItalyUnit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome 00128, ItalyResearch Unit of Neurophysiology and Neuroengineering of Human-Technology Interaction (NeXTlab), Università Campus Bio-Medico di Roma, Rome 00128, ItalyThe exact relationship between cognitive functioning, cortical excitability, and synaptic plasticity in dementia is not completely understood. Vascular cognitive impairment (VCI) is deemed to be the most common cognitive disorder in the elderly since it encompasses any degree of vascular-based cognitive decline. In different cognitive disorders, including VCI, transcranial magnetic stimulation (TMS) can be exploited as a noninvasive tool able to evaluate in vivo the cortical excitability, the propension to undergo neural plastic phenomena, and the underlying transmission pathways. Overall, TMS in VCI revealed enhanced cortical excitability and synaptic plasticity that seem to correlate with the disease process and progression. In some patients, such plasticity may be considered as an adaptive response to disease progression, thus allowing the preservation of motor programming and execution. Recent findings also point out the possibility to employ TMS to predict cognitive deterioration in the so-called “brains at risk” for dementia, which may be those patients who benefit more of disease-modifying drugs and rehabilitative or neuromodulatory approaches, such as those based on repetitive TMS (rTMS). Finally, TMS can be exploited to select the responders to specific drugs in the attempt to maximize the response and to restore maladaptive plasticity. While no single TMS index owns enough specificity, a panel of TMS-derived measures can support VCI diagnosis and identify early markers of progression into dementia. This work reviews all TMS and rTMS studies on VCI. The aim is to evaluate how cortical excitability, plasticity, and connectivity interact in the pathophysiology of the impairment and to provide a translational perspective towards novel treatments of these patients. Current pitfalls and limitations of both studies and techniques are also discussed, together with possible solutions and future research agenda.http://dx.doi.org/10.1155/2020/8820881 |
| spellingShingle | Mariagiovanna Cantone Giuseppe Lanza Francesco Fisicaro Manuela Pennisi Rita Bella Vincenzo Di Lazzaro Giovanni Di Pino Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation Neural Plasticity |
| title | Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation |
| title_full | Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation |
| title_fullStr | Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation |
| title_full_unstemmed | Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation |
| title_short | Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation |
| title_sort | evaluation and treatment of vascular cognitive impairment by transcranial magnetic stimulation |
| url | http://dx.doi.org/10.1155/2020/8820881 |
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