Effect of transcranial magnetic stimulation on action naming in patients with Alzheimer disease.

OBJECTIVE To assess the effect of repetitive transcranial magnetic stimulation (rTMS) to the dorsolateral prefrontal cortex (DLPFC) on picture naming in patients with Alzheimer disease (AD). DESIGN Experimental study. Patients with AD underwent rTMS in real and control conditions during picture-naming tasks. SETTING San Giovanni di Dio Fatebenefratelli Scientific Institute in Brescia, Italy. Patients Fifteen patients with probable AD. Intervention High-frequency rTMS was applied to the left and right DLPFC during object and action naming. MAIN OUTCOME MEASURES Language ability was assessed by accuracy of verbal response during online rTMS. RESULTS Stimulation to the left and right DLPFC improved accuracy in action naming. CONCLUSIONS These findings indicate that rTMS to the DLPFC, which speeds up action naming in normal controls, improves performance in patients with AD. While the mechanisms of rTMS-induced naming facilitation in these patients are unknown, the procedure may be worth testing as a novel approach to the treatment of language dysfunction.

[1]  Á. Pascual-Leone,et al.  Improved picture naming in chronic aphasia after TMS to part of right Broca’s area: An open-protocol study , 2005, Brain and Language.

[2]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[3]  C. Thompson,et al.  Patterns of Comprehension and Production of Nouns and Verbs in Agrammatism: Implications for Lexical Organization , 2000, Brain and Language.

[4]  E. Wassermann.  Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996. , 1998, Electroencephalography and clinical neurophysiology.

[5]  D. Perani,et al.  The neural correlates of verb and noun processing. A PET study. , 1999, Brain : a journal of neurology.

[6]  Alfonso Caramazza,et al.  Cortical signatures of noun and verb production , 2006, Proceedings of the National Academy of Sciences of the United States of America.

[7]  Ronald Peeters,et al.  Anterior temporal laterality in primary progressive aphasia shifts to the right , 2005, Annals of neurology.

[8]  S. Cappa,et al.  Object and action naming in Alzheimer's disease and frontotemporal dementia , 1998, Neurology.

[9]  Lars Nyberg,et al.  Age-Related Differences in Neural Activity during Item and Temporal-Order Memory Retrieval: A Positron Emission Tomography Study , 2000, Journal of Cognitive Neuroscience.

[10]  A. Caramazza,et al.  On the Basis for the Agrammatic's Difficulty in Producing Main Verbs , 1984, Cortex.

[11]  Thomas E. Nichols,et al.  Compensatory reallocation of brain resources supporting verbal episodic memory in Alzheimer's disease , 1996, Neurology.

[12]  P M Rossini,et al.  The role of the left frontal lobe in action naming: rTMS evidence , 2002, Neurology.

[13]  Gennaro Chierchia,et al.  Noun–verb dissociation in aphasia: The role of imageability and functional locus of the lesion , 2006, Neuropsychologia.

[14]  V E Amassian,et al.  Human cerebral cortical responses to contralateral transcranial stimulation. , 1987, Neurosurgery.

[15]  Claudio Babiloni,et al.  Age-Related Functional Changes of Prefrontal Cortex in Long-Term Memory: A Repetitive Transcranial Magnetic Stimulation Study , 2004, The Journal of Neuroscience.

[16]  G. Gainotti,et al.  Evidence for a possible neuroanatomical basis for lexical processing of nouns and verbs , 1994, Neuropsychologia.

[17]  J L Andersson,et al.  Brain regions associated with episodic retrieval in normal aging and Alzheimer’s disease , 1999, Neurology.

[18]  M. D’Esposito,et al.  Category-specific difficulty naming with verbs in Alzheimer's disease , 1996, Neurology.

[19]  Á. Pascual-Leone,et al.  Interindividual variability of the modulatory effects of repetitive transcranial magnetic stimulation on cortical excitability , 2000, Experimental Brain Research.

[20]  J. Vizmuller-Zocco,et al.  Lessico di frequenza dell'italiano parlato , 1994 .