Circuit-based neuromodulation enhances delayed recall in amnestic mild cognitive impairment,Journal of Neurology, Neurosurgery, and Psychiatry

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Circuit-based neuromodulation enhances delayed recall in amnestic mild cognitive impairment
Journal of Neurology, Neurosurgery, and Psychiatry ( IF 11.0 ) Pub Date : 2024-03-19 , DOI: 10.1136/jnnp-2023-333152
Jie Ma , Jia-Jia Wu , Xiang-Xin Xing , Xin Xue , Yun-Ting Xiang , Xiao-Min Zhen , Jian-Hua Li , Juan-Juan Lu , Jun-Peng Zhang , Mou-Xiong Zheng , Xu-Yun Hua , Jian-Guang Xu

Background This study aimed to investigate the efficacy of circuits-based paired associative stimulation (PAS) in adults with amnestic mild cognitive impairment (aMCI). Methods We conducted a parallel-group, randomised, controlled clinical trial. Initially, a cohort of healthy subjects was recruited to establish the cortical-hippocampal circuits by tracking white matter fibre connections using diffusion tensor imaging. Subsequently, patients diagnosed with aMCI, matched for age and education, were randomly allocated in a 1:1 ratio to undergo a 2-week intervention, either circuit-based PAS or sham PAS. Additionally, we explored the relationship between changes in cognitive performance and the functional connectivity (FC) of cortical-hippocampal circuits. Results FCs between hippocampus and precuneus and between hippocampus and superior frontal gyrus (orbital part) were most closely associated with the Auditory Verbal Learning Test (AVLT)\_N5 score in 42 aMCI patients, thus designated as target circuits. The AVLT\_N5 score improved from 2.43 (1.43) to 5.29 (1.98) in the circuit-based PAS group, compared with 2.52 (1.44) to 3.86 (2.39) in the sham PAS group (p=0.003; Cohen’s d=0.97). A significant decrease was noted in FC between the left hippocampus and left precuneus in the circuit-based PAS group from baseline to postintervention (p=0.013). Using a generalised linear model, significant group×FC interaction effects for the improvements in AVLT_N5 scores were found within the circuit-based PAS group (B=3.4, p=0.017). Conclusions Circuit-based PAS effectively enhances long-term delayed recall in adults diagnosed with aMCI, which includes individuals aged 50–80 years. This enhancement is potentially linked to the decreased functional connectivity between the left hippocampus and left precuneus. Trial registration number ChiCTR2100053315; Chinese Clinical Trial Registry. Data are available upon reasonable request.

更新日期：2024-03-20

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