{"doi":"10.3389/fnagi.2020.00200","title":"Corticomotor Plasticity Predicts Clinical Efficacy of Combined Neuromodulation and Cognitive Training in Alzheimer’s Disease","abstract":"Objective: To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training for treatment of cognitive symptoms in patients with Alzheimer’s Disease (AD). A secondary objective was to analyze associations between brain plasticity and cognitive effects of treatment. Methods: In this randomized, sham-controlled, multicenter clinical trial, 34 patients with AD were assigned to three experimental groups receiving 30 daily sessions of combinatory intervention. Participants in the real/real group (n=16) received 10Hz repetitive transcranial magnetic stimulation (rTMS) delivered separately to each of six cortical regions, interleaved with computerized cognitive training. Participants in the sham rTMS group (n=18) received sham rTMS combined with either real (sham/real group, n=10) or sham (sham/sham group, n=8) cognitive training. Effects of treatment on neuropsychological (primary outcome) and neurophysiological function were compared between the 3 treatment groups. These, as well as imaging measures of brain atrophy, were compared at baseline to 14 healthy controls (HC). Results: At baseline, patients with AD had worse cognition, cerebral atrophy, and TMS measures of cortico-motor reactivity, excitability, and plasticity than HC. The real/real group showed significant cognitive improvement compared to the sham/sham, but not the real/sham group. TMS-induced plasticity at baseline was predictive of post-intervention changes in cognition, and was modified across treatment, in association with changes of cognition. Interpretation: Combined rTMS and cognitive training may improve the cognitive status of AD patients, with TMS-induced cortical plasticity at baseline serving as predictor of therapeutic outcome for this intervention, and potential mechanism of action. Registered at ClinicalTrials.gov NCT01504958.","journal":"Frontiers in Aging Neuroscience","year":2020,"id":58844,"datarank":1.6579375211289218,"base_score":4.2626798770413155,"endowment":4.2626798770413155,"self_citation_contribution":0.6394019815561974,"citation_network_contribution":1.0185355395727245,"self_endowment_contribution":0.6394019815561974,"citer_contribution":1.0185355395727245,"corpus_percentile":null,"corpus_rank":null,"citation_count":70,"citer_count":52,"citers_with_citation_signal":38,"citers_with_endowment":38,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9266,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT01504958"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":308745,"name":"Riccardo Di Iorio","orcid":"0000-0002-8913-2151","position":1,"is_corresponding":false},{"id":258899,"name":"Peter J. Fried","orcid":"0000-0001-6041-2996","position":2,"is_corresponding":false},{"id":263187,"name":"Albino J. Oliveira‐Maia","orcid":"0000-0001-5071-3007","position":3,"is_corresponding":false},{"id":308746,"name":"Camillo Marra","orcid":"0000-0003-3994-4044","position":4,"is_corresponding":false},{"id":308747,"name":"Paolo Profice","orcid":"0000-0001-9923-9246","position":5,"is_corresponding":false},{"id":308748,"name":"Davide Quaranta","orcid":"0000-0003-2905-6625","position":6,"is_corresponding":false},{"id":310032,"name":"Lukas Schilberg","orcid":null,"position":7,"is_corresponding":false},{"id":310033,"name":"Natasha Atkinson","orcid":null,"position":8,"is_corresponding":false},{"id":310034,"name":"Erica Seligson","orcid":null,"position":9,"is_corresponding":false},{"id":106058,"name":"Paolo Maria Rossini","orcid":"0000-0003-2665-534X","position":10,"is_corresponding":false},{"id":106052,"name":"Álvaro Pascual‐Leone","orcid":"0000-0001-8975-0382","position":11,"is_corresponding":false},{"id":308744,"name":"Anna‐Katharine Brem","orcid":"0000-0003-0295-6834","position":0,"is_corresponding":true}],"reference_count":58,"raw_metadata":null,"created_at":"2026-07-18T21:07:33.416320Z","pmid":"32733232","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}