Format

Send to:

Choose Destination
See comment in PubMed Commons below
Brain Stimul. 2014 Mar-Apr;7(2):308-13. doi: 10.1016/j.brs.2013.10.003. Epub 2013 Oct 25.

Effects of a non-focal plasticity protocol on apathy in moderate Alzheimer's disease: a randomized, double-blind, sham-controlled trial.

Author information

  • 1Discipline of Geriatrics, Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. Electronic address: cksuemoto@usp.br.
  • 2Discipline of Geriatrics, Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.
  • 3Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil.
  • 4Department of Pathology, LIM/22, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.
  • 5Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.
  • 6Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Abstract

BACKGROUND:

Apathy is the most common neuropsychiatric symptom in Alzheimer's disease (AD) and it is associated with changes in prefrontal neural circuits involved with generation of voluntary actions. To date no effective treatment for apathy has been demonstrated.

OBJECTIVE:

We aimed to investigate the effects and safety of repetitive transcranial direct current stimulation (tDCS) on apathy in moderate AD patients.

METHODS:

Forty patients were randomized to receive either active or sham-tDCS over the left dorsolateral prefrontal cortex (DLPFC). Patients received six sessions of intervention during 2 weeks and were evaluated at baseline, at week 1 and 2, and after 1 week without intervention. Clinical raters, patients, and caregivers were blinded. The primary outcome was apathy. Global cognition and neuropsychiatric symptoms were examined as secondary outcomes.

RESULTS:

The mean MMSE score at baseline was 15.2 ± 2.9 and the mean Apathy Scale score was 27.7 ± 6.7. Changes on apathy scores over time were not different between active and sham tDCS (P = 0.552 for repeated measures). Further analyses confirm that changes from baseline did not differ between groups after the sixth session (active tDCS -1.95 (95%CI -3.49, -0.41); sham-tDCS -2.05 (95%CI -3.68, -0.42); P = 0.989]. Similarly, tDCS had no effect on secondary outcomes (P > 0.40). tDCS was well tolerated and not associated with significant adverse effects.

CONCLUSION:

In this adequately powered study for minimal clinically significant difference, our findings show that using the parameters we chose for this study, repeated anodal tDCS over the left DLPFC had no effect on apathy in elderly patients with moderate AD.

Copyright © 2014 Elsevier Inc. All rights reserved.

KEYWORDS:

Alzheimer's disease; Apathy; Cognition; Dementia; Depression; Transcranial direct current stimulation

PMID:
24262299
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk