Cortical plasticity, therapeutic effects, and neural circuit activity of angular gyrus rTMS in amnestic mild...

This study aimed to explore the neurophysiological mechanisms behind the improvement of cognitive functions through angular gyrus repetitive transcranial magnetic stimulation (rTMS) in patients with amnestic mild cognitive impairment (aMCI) by assessing cortical plasticity, underscoring the predictive value of cortical plasticity for clinical outcomes.

Twenty-seven aMCI patients were allocated to the intervention and control groups for 4 weeks of 20 Hz rTMS of the angular gyrus. Long-term potentiation (LTP)-like cortical plasticity in the motor M1 area, in conjunction with neuropsychological tests and resting-state brain imaging, was used to investigate the mechanism behind angular gyrus rTMS.

At baseline, aMCI patients presented impaired LTP-like motor cortical plasticity related to cognitive damage. Following treatment with angular gyrus rTMS, a reversal in the impairment of this plasticity was observed. This improvement was associated with clinical efficacy in terms of cognitive function and changes in the resting-state brain network activities of the sensorimotor, default mode, and frontoparietal networks.

Clinical symptoms are alleviated by angular gyrus rTMS, and damaged cortex plasticity also shows signs of improvement, potentially linked to transcortical neural activity across multiple brain regions in aMCI patients. Cortical plasticity induced by transcranial magnetic stimulation has potential value in predicting the clinical outcomes of neuromodulation.

Motor cortex plasticity may be related to cognitive function and therapeutic effects in aMCI patients and may be modulated by angular gyrus transcranial magnetic stimulation.