Effect of accelerated repetitive transcranial magnetic stimulation in mild neurocognitive impairment

Mild Neurocognitive Disorder (MCI) is a clinical condition in which there is measurable cognitive impairment, but daily living activities are not completely impaired and functionality is preserved. The individual with MCI is in a pathological transition phase between the normal aging process and dementia. Transcranial magnetic stimulation (TMS) is a somatic treatment application in which the magnetic field generated by a coil through which electric current passes stimulates nerve cells. There are studies conducted with TMS in individuals with MCI. To date, no randomized controlled double-blind study has been found in which 2 sessions of TMS were applied per day in this population. In this study, MCI patients who met the diagnostic criteria according to DSM-V and were divided into two groups by double-blind random method; High frequency (10 Hz) accelerated r TMS was applied to the left dorsolateral prefrontal cortex, 2 sessions per day, for a total of 20 sessions (1,000 beats/session). This study aimed to investigate whether rTMS application is effective on cognitive symptoms in MCI and the anxiety and depression symptoms accompanying MCI, and if so, how long it lasts. 20 sessions of real TMS and 20 sessions of sham TMS were applied to the participants in the study. No intervention was made to the patients' existing psychiatric pharmacotherapies, and the treatments they were using during the research period were continued at the same dose. In clinical evaluation, patients were given the Hamilton Depression Rating Scale (HAM-D), Hamilton Depression Rating Scale (HAM-D) 4 times in total, before the treatment, at the end of the 10th session of TMS (day 5), at the end of the 20 sessions of TMS (day 10), and in the 2nd month after the completion of TMS application. Anxiety Rating Scale (HAM-A), Wisconsin Card Sorting Test, Stroop Test, Digit Span Test, Verbal Memory Processes Test, WAIS Similarity and Judgment Test were administered. All applications were performed by the researcher who was blind to the treatment process. At the end of the study, positive changes in cognitive functions were detected in the group receiving real TMS. It was also observed that the anxiety and depression scores of the patients decreased. It was observed that the improvements were more evident and in more areas in the group receiving real TMS, and the positive effect in the group receiving real TMS was found to be more permanent than in the imitation TMS group. The results showed that TMS application was beneficial to cognitive symptoms in MCI and that the positive effect lasted for at least two months. Keywords: Mild Cognitive Impairment, Transcranial Magnetic Stimulation, Cognitive Functions