TMS Therapy for Prevention of Cognitive Decline

But gradually, cognitive decline could evolve into a loss of train of thoughts during a conversation or losing the storyline while reading books or watching movies. Such experiences, result into a feeling of being overwhelmed, especially for the situations requiring decisions at home, or planning steps for implementing a task at work, or even being able to follow instructions given by a physician or your boss at work.
Most people attribute these to the natural aging process until it deteriorates into situations like losing your way while driving home, or trouble finding your way around home or other familiar environments. This cognitive decline results into becoming more impulsive, that causes having steadily poor judgment.

Recent evidence indicates that cognitive decline and MCI might be due to reduced blood flow through brain blood vessels. Brain-imaging studies show that stimulation of the brain could be beneficial in impeding events that cause cognitive impairment. Transcranial magnetic stimulation (TMS) is a technique that can selectively stimulate specific brain regions non-invasively.
This is particularly important since there aren’t that many other options available. In fact, the absence of effective pharmacological options for prevention of cognitive impairment is depicted in 2018 report of the American Academy of Neurology¹ in which it is recommended that “Clinicians should discuss diagnosis, prognosis, long-term planning, and the lack of effective medicine options …”.

VaD includes subtypes, such as post-stroke dementia, multi-infarct dementia, strategic infarct dementia, and the subcortical ischemic VaD. In addition to vascular-based dementia there is also degenerative dementia (which is most common in Alzheimer’s disease)⁸. Combining these two types, covers the majority of cases of dementia. However, VCI is the most common cognitive disorder that comes with age and because of that has a high impact on patients’ quality of life.

Because of the fact that vascular-based impairment is the root cause of all types of cognitive decline, approaches that can prevent such considerable deficits have the potential of making life changing effects for many people in latter parts of their lives^9,10. In this regard, many research results have shown that cognitive decline is treatable and preventable and they are not an irreversible consequence of aging.

Patients will receive a second fMRI after the last session to compare baseline and post-treatment brain maps to calculate the efficacy measure. Patients will also receive another fMRI at one-year follow-up to monitor evolution of brain activity and connectivity, and the need of another cycle of 20 sessions with fMRI guided TMS will be assessed by our biomarkers, and delivered as needed over the course of the lifespan. Our findings with MCI patients suggest that fMRI guided TMS could be an effective therapy for preventing cognitive decline and probably a tool to delay deterioration.