February 28, 2023, by mbzva

A non-pharmacological approach to treating Alzheimer’s Disease

By Argyro Philippidou, 3rd Year Neuroscience BSc

I came across this treatment technique this summer during my internship. It’s called TMS which stands for Transcranial Magnetic Stimulation. What it does it sends magnetic pulses through a handheld controller which is projected on the designated brain region a scientist would want to stimulate. So how could this help in treating Alzheimer’s disease?

Firstly, TMS has been a topic of investigation for decades now. It is a non-invasive neurorehabilitation tool that has been shown to improve cognition in patients with Alzheimer’s (Zhao et al, 2017). Although it sounds like a complex technique, in actuality its basic concept is very simple. Think of it like drinking too much water at once, at first you might feel a bit nauseous but then everything eventually balances out and you feel better. In corelation to science, it stimulates areas of the brain influenced by Alzheimer’s disease, like the hippocampus the entorhinal cortex and the precuneus, even more than they are usually active, thus enhancing the activation of neurons in the brain. However, then it causes the reestablishment of balance of neurotransmitters such as glutamate (Olajide OJ. Et al., 2021), the decrease of reactive oxygen species (Bhat S. et al, 2021) and neuroinflammation (Hur JY et al., 2020) as well as the decrease of the primary constitute of Alzheimer’s the misfolding and aggregation of tau proteins (Udin MS. Et al., 2020). By affecting all these internal brain mechanisms, it also improves the main cognitive deficit of Alzheimer’s, memory decline.

There are many types of memories including working memory, episodic memory, semantic memory, long term memory and short-term memory. Alzheimer’s disease primarily affects episodic memory. This type of memory consists of information from recent or past events. Therefore, people with Alzheimer’s disease have difficulty in recalling events from the past. Pharmacological treatments have not yet been evidently successful in improving episodic memory alone.

2022 Study conducted at the University of Technology in Cyprus by Artemis Traikapi has shown that TMS treatment improved episodic memory recall of Alzheimer’s patients up to 3 months post treatment (Traikapi A et al., 2022). Patients’ memories were assessed and compared before and after TMS treatment using “word learning and logical memory tests” (Traikapi A., et al., 2022). Both tests and all psychological assessments had improved up to 3 months post TMS treatment. This type of treatment also subsided patients’ anxiety symptoms associated with the disease (Traikapi A. et al, 2022). More research however has to be done as only 4 patients represent these results and although significant, a greater population of Alzheimer patients has to be reached out and tested in order for TMS to establish its reliable reputation.

Although TMS is not always suitable for all people, for example for people with a genetic predisposition to epileptic seizures or people that have had epileptic episodes before. However, for patients that have no epileptic risk and are in need of TMS therapy, side effects are very minimal to none and lately TMS has also been used to treat patients with other neurological and mental diseases such as depression (Mussigmann et al., 2021) and chronic pain (Fitzgerald & Watson, 2018). This non-invasive neurorehabilitation treatment can therefore open new therapeutic doors for patients who decide to take a non-pharmacological route.

 

References:

  • Bhatt S, Puli L and Patil CR: Role of reactive oxygen species in the progression of Alzheimer’s disease. Drug Discov Today. 26:794–803. 2021. View ArticleGoogle Scholar : PubMed/NCBI
  • Fitzgerald, P. J., & Watson, B. O. (2018). Gamma oscillations as a biomarker for major depression: An emerging topic. Translational Psychiatry, 8(1), 1–7. https://doi.org/10.1038/s41398-018-0239-y
  • Hur JY, Frost GR, Wu X, Crump C, Pan SJ, Wong E, Barros M, Li T, Nie P, Zhai Y, et al: The innate immunity protein IFITM3 modulates γ-secretase in Alzheimer’s disease. Nat Aust. 586:735–740. 2020. View ArticleGoogle Scholar : PubMed/NCBI
  • Mussigmann, T., Lefaucheur, J. P., & McGonigal, A. (2021). Gamma-band activities in the context of pain: A signal from brain or muscle? Neurophysiologie Clinique, 51, 287–289. https://doi.org/10.1016/j.neucli.2021.03.007
  • Olajide OJ, Gbadamosi IT, Yawson EO, Arogundade T, Lewu FS, Ogunrinola KY, Adigun OO, Bamisi O, Lambe E, Arietarhire LO, et al: Hippocampal degeneration and behavioral impairment during Alzheimer-like pathogenesis involves glutamate excitotoxicity. J Mol Neurosci. 71:1205–1220. 2021. View ArticleGoogle Scholar : PubMed/NCBI
  • Traikapi, A., Kalli, I., Kyriakou, A., Stylianou, E., Symeou, R.T., Kardama, A., Christou, Y.P., Phylactou, P. and Konstantinou, N. (2022). Episodic memory effects of gamma frequency precuneus transcranial magnetic stimulation in Alzheimer’s disease: A randomized multiple baseline study. Journal of Neuropsychology. [online] doi:10.1111/jnp.12299.
  • Uddin MS, Al Mamun A, Rahman M, Behl T, Perveen A, Hafeez A, Bin-Jumah MN, Abdel-Daim MM and Ashraf GM: Emerging proof of protein misfolding and interactions in multifactorial Alzheimer’s disease. Curr Top Med Chem. 20:2380–2390. 2020. View ArticleGoogle Scholar : PubMed/NCBI
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