Abstract

Alzheimer's Disease (AD) is a neurodegenerative disease that leads to progressive cognitive decline involving multiple domains. Repetitive transcranial magnetic stimulation (rTMS) has been an established treatment for mood disorders, most notably the treatment of resistant major depressive disorder. Numerous clinical trials have shown rTMS to be an effective treatment for individuals with AD. The majority of rTMS trials for the treatment of AD applied high-frequency (>10 Hz) stimulation parameters over several weeks (e.g., 4-6 weeks). We report a case report of a 77-year-old patient with severe Alzheimer’s disease who underwent 50 sessions of intermittent theta burst stimulation (iTBS) rTMS over 10 days. Cognitive assessment using Mini-Mental State Examination (MMSE) showed improvement by 6 points from baseline at the end of treatment. All TMS treatment sessions were applied using a figure-of-eight coil (CloudTMS Neurosoft Ltd, Russia) under MRI navigation (Neural Navigator, Brain Science tools, Netherlands).

The patient underwent five daily sessions of rTMS, with a 30-minute break between sessions. Cortical targets included the left and right dorsolateral prefrontal cortex (DLPFC), superior parietal lobule (SPL), and precuneus. A one-month follow-up post-treatment showed sustained effects of rTMS, as the patient could recall family members' names and began engaging in daily activities again.

To our knowledge, this is the first case report on the significant results of using iTBS for more than 10 days to treat AD.