Efficacy of the my health too online cognitive behavioral therapy program for healthcare workers during the COVID-19 pandemic: A randomized controlled trial.

Background: Healthcare workers' mental health has been impacted by the COVID-19 pandemic, emphasizing the need for mental health interventions in this population. Online cognitive behavioral therapy (CBT) is efficient to reduce stress and may reach numerous professionals. We developed "MyHealthToo", an online CBT program to help reduce stress among healthcare workers during the COVID-19 pandemic. Objective: The aim of our study is to investigate the efficacy of an online CBT program on stress and mental health conditions among healthcare workers during a health crisis. Methods: We performed a multicentric randomized controlled trial among 155 participants allocated either to the experimental or active control group (bibliotherapy). The primary outcome was the decrease of perceived stress scores (PSS-10) post-treatment. Secondary outcomes included depression, insomnia and PTSD symptoms along with self-reported resilience and ruminations. Assessments were scheduled pretreatment, mid-treatment (4 weeks), post-treatment (8 weeks), and at 1-month and 4-months follow-up. Results: For both interventions, mean changes on the PSS-10 were significant post-therapy (W8), as at 1-month (W12) and 4-months (W24) follow-ups. The between-group comparison showed no difference at any time point (ps > 0.88). Work-related ruminations significantly decreased in the experimental group with a significant between-group difference at W8 (Δ = -1.83 [-3.57; -0.09], p = 0.04). Posttraumatic stress symptoms significantly decreased in the experimental group with a significant between-group difference at W12 (Δ = -1.41 [-2.68; -0.14], p = 0.03). The decrease in work-related ruminations at W8 mediated the decrease in posttraumatic stress symptoms at W12 (p = 0.048). Conclusion: The "MyHealthToo" online CBT intervention may help reduce ruminations about work and posttraumatic stress symptoms among healthcare workers during a major health crisis. Work-related ruminations may represent a relevant target of online interventions to improve mental health among healthcare workers.

Impact of online poker gambling on behavioural and neurophysiological responses to a virtual gambling task.

Online poker gambling (OPG) involves various executive control processes and emotion regulation. In this context, we hypothesized that online poker players, accustomed to handling virtual cards, would show high performance on computerized decision-making tasks such as the Iowa Gambling Task (IGT). Using press advertisements, we recruited a non-gambler group (NG; n = 20) and an OPG group (n = 22). All participants performed the IGT while their cerebral activity was recorded by electroencephalography. Compared with the OPG group, the NG group showed significantly better progression in the IGT in the last trials. Recording of brain activity revealed the appearance of a temporal map between 150 and 175 ms specific to the gain condition in both groups. A second map was observed at 215-295 ms specifically in the NG group, and the generators were identified in the occipital regions. This activity is indicative of a high level of visual awareness; thus, it reflects additional processing of visual information, which can be assumed to be induced by the lower exposure of the NGs to online card games. We hypothesize that the absence of this activity in the OPG group might be due to their online habituation to virtual environments.

Acute effect of transcranial direct current stimulation (tDCS) on postural control of trained athletes: A randomized controlled trial.

Transcranial direct current stimulation (tDCS) is used to modulate brain function, and can modulate motor and postural control. While the acute effect of tDCS is well documented on patients, little is still known whether tDCS can alter the motor control of healthy trained participants. This study aimed to assess the acute effect of tDCS on postural control of parkour practitioners, known for their good balance abilities and their neuromuscular specificities that make them good candidates for tDCS intervention. Eighteen parkour practitioners were tested on three occasions in the laboratory for each stimulation condition (2 mA; 20 minutes)-primary motor cortex (M1), dorsolateral prefrontal cortex (dlPFC) and sham (placebo). Postural control was evaluated PRE and POST each stimulation by measuring Center of Pressure (CoP) displacements on a force platform during static conditions (bipedal and unipedal stance). Following M1 stimulation, significant decreases were observed in CoP area in unipedal (from 607.1 ± 297.9 mm2 to 451.1 ± 173.9 mm2, P = 0.003) and bipedal (from 157.5 ± 74.1 mm2 to 117.6 ± 59.8 mm2 P<0.001) stances. As well, the CoP total length was significantly reduced in bipedal (from 3416.8 ± 295.4 mm to 3280.6 ± 306.2 mm, P = 0.005) as well as in unipedal stance (from 4259.6 ± 398.4 mm to 3846.5 ± 468.9 mm, P<0.001), only after M1 stimulation. Relative pre-post changes observed after M1 stimulation were negatively correlated to experience in parkour only after unipedal stance (r = 0.715, P<0.001), meaning that the more participants were trained the less tDCS was effective. No significant changes were noticed after sham and dlPFC stimulation. These results suggested that the modulation of gait performance in athletes following an acute intervention of tDCS is specific to the targeted brain region, and that postures with reduced base of support (such as unipedal stance) were more sensitive to tDCS.

Predictors of Gaming Disorder or Protective from It, in a French Sample: A Symptomatic Approach to Self-Regulation and Pursued Rewards, Providing Insights for Clinical Practice.

Gaming disorder (GD) is a new health condition still requiring a lot of evidence established around its underlying and related psychological mechanisms. In our study we focused on Massively Multiplayer Online Role Playing Games (MMORPGs), a specific very popular and engaging game genre, to determine that benefit, motivation and control aspects could be predictive of a dysfunctional engagement in gaming. In total, 313 participants were recruited from private forums of gamers between May 2009 and March 2010. They filled out a questionnaire on their socio-demographic data and their weekly gaming time. They also completed different psychometric assessments such as the DSM IV-TR criteria for substance dependence adapted to gaming such as the Dependence Adapted Scale (DAS), the external rewards they expected from gaming (External Motives), the expected internal reward they expected from gaming (Internal Motives), the Zuckerman Sensation Seeking Scale (ZSSS), and the Barratt impulsiveness Scale (BIS-10). Results showed that some psychological factors related to online gaming represented risk factors for GD in participants (i.e., competition and advancement motives, reduced anxiety, solace, greater personal satisfaction, and sense of power), whereas some others were found to be protective factors from GD (i.e., recreation, enjoyment and experience seeking) in participants. Additionally, the study found that disinhibition, boredom susceptibility, thrill and adventure seeking, and high impulsivity were correlated to GD in participants. In conclusion, not only motives for gaming and impulsivity could be predictors for GD, but maladaptive coping strategies based on experienced relief in-game from negative feelings (anxiety and boredom) or experienced improvement in-game of self-perception (personal satisfaction, sense of power) could play as well a role of negative reinforcers for GD. Some benefits from gaming, typically entertainment and enjoyment, are shown to be protective factors from GD, playing the role of positive reinforcing factors. They are worthy of being identified and promoted as functional gaming habits. These findings can feed the clinical and health promotion fields, with a more in-depth understanding of diverse psychological factors in gamers, identifying those at risk for GD and those protective from it. The current work can foster a more balanced approach towards gaming activities, taking their opportunities for mankind and controlling for their adverse effects in some individuals.

Do Individuals with Internet Gaming Disorder Share Personality Traits with Substance-Dependent Individuals?

(1) Background: Internet gaming disorder (IGD) shares many similarities with substance use disorder (SUD), contributing to its recognition as an addictive disorder. Nevertheless, no study has compared IGD to other addictive disorders in terms of personality traits established as highly co-occurring with SUDs. (2) Methods: We recruited a sample of gamers (massively multiplayer online role-playing games) (MMORPGs) via online in-game forums. We compared 83 individuals with IGD (MMORPG-IGD group) to 47 former heroin addicts under methadone maintenance treatment (MMT; MMT group) with regard to alexithymia, impulsivity, sensation seeking and aggressiveness assessed through self-administered scales, being TAS-20, BIS-10, Z-SSS and BDHI, respectively. (3) Results: Our results draw a relatively similar personality profile between groups but indicate that the subject traits are generally more pronounced in the MMT cohort. The overall lesser intensity of these traits in the MMORPG-IGD group might reflect the greater variability in the severity of the IGD. (4) Conclusions: IGD shares personality traits with MMT, and intensity may be influenced by the severity of the addiction or by certain direct environmental factors, and might also influence the propensity towards one behavior rather than another.

Repetitive Transcranial Magnetic Stimulation as an Add-On Treatment for Cognitive Impairment in Alzheimer's Disease and Its Impact on Self-Rated Quality of Life and Caregiver's Burden.

Alzheimer's disease (AD) is associated with progressive memory loss and decline in executive functions, as well as neuropsychiatric symptoms. Patients usually consider quality of life (QoL) and mood as more important for their health status than disease-specific physical and mental symptoms. In this open-label uncontrolled trial, 12 subjects diagnosed with AD underwent 10 sessions of repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (10 Hz, 20 min, 2000 pulses/day, 110% MT). Outcomes were measured before and 30 days after treatment. Our primary objective was to test the efficacy of rTMS as an add-on treatment for AD on the global cognitive function, assessed through the Mini-Mental State Examination (MMSE) and the Mattis Dementia Rating Scale (MDRS). As secondary objectives, the detailed effect on cognitive functions, depression and anxiety symptoms, QoL, and functionality in daily life activities were evaluated, as well as correlations between QoL and cognition, depression and anxiety scores. The treatment significantly enhanced semantic memory and reduced anxiety. Improvement of these features in AD could become an important target for treatment strategies. Although limited by its design, this trial may contribute with another perspective on the analysis and the impact of rTMS on AD.

Towards a Functional Neuromarker of Impulsivity: Feedback-Related Brain Potential during Risky Decision-Making Associated with Self-Reported Impulsivity in a Non-Clinical Sample.

Risk-taking is part of the multidimensional nature of impulsivity, consisting of an active engagement in behaviors or choices with potentially undesirable results, with probability as the cost for an expected reward. In order to understand the neurophysiological activity during risky behavior and its relationship with other dimensions of impulsivity, we have acquired event-related-potential (ERP) data and self-reported impulsivity scores from 17 non-clinical volunteers. They underwent high-resolution electroencephalography (HR-EEG) combined with an adapted version of the Balloon Analogue Risk Task (BART), and completed the Barratt Impulsiveness Scale (BIS-10) and the Urgency, Premeditation, Perseverance, Sensation Seeking, Impulsive Behavior Scale (UPPS). The ERP components were sensitive to valence (FRN, P300) and risk/reward magnitude (SPN, RewP). Our main finding evidenced a positive correlation between the amplitude of the P300 component following positive feedback and both the global UPPS score and the (lack of) perseverance UPPS subscale, significant for several adjacent electrodes. This finding might suggest an adaptive form of impulsive behavior, which could be associated to the reduction on the difference of the P300 amplitude following negative and positive feedback. However, further investigation with both larger clinical and non-clinical samples is required.

Effect of transcranial direct current stimulation on the psychomotor, cognitive, and motor performances of power athletes.

In sports science, transcranial direct current stimulation (tDCS) has many unknown effects on neuromuscular, psychomotor and cognitive aspects. Particularly, its impact on power performances remains poorly investigated. Eighteen healthy young males, all trained in a jumping sport (parkour) performed three experimental sessions: anodal tDCS applied either on the left dorsolateral prefrontal cortex (dlPFC, cathode in supraorbital area) or on the primary motor cortex (M1, cathode on contralateral shoulder), and a placebo condition (SHAM), each applied for 20 min at 2 mA. Pre and post, maximal vertical and horizontal jumps were performed, associated to leg neuromuscular assessment through electromyography and peripheral nerve stimulations. Actual and imagined pointing tasks were also performed to evaluate fine motor skills, and a full battery of cognitive and psychomotor tests was administered. M1 tDCS improved jump performance accompanied by an increase in supraspinal and spinal excitabilities. dlPFC stimulation only impacted the pointing tasks. No effect on cognitive tests was found for any of the tDCS conditions. To conclude, the type of performance (maximal versus accurate) affected depended upon the tDCS montage. Finally, athletes responded well to tDCS for motor performance while results to cognitive tests seemed unaffected, at least when implemented with the present rationale.

Behavioral and Neural Arguments of Motivational Influence on Decision Making During Uncertainty.

The scientific world is increasingly interested in motivation, primarily due to the suspected impact on decision-making abilities, particularly in uncertain conditions. To explore this plausible relationship, 28 healthy participants were included in the study and performed decision-making and motivational tasks while their neural activity was recorded. All participants performed the Iowa Gambling Task (IGT) and were split into two groups based on their score, one favorable group with 14 participants who performed advantageously and one undecided group with 14 participants who failed to develop the correct strategy on the IGT. In addition, all participants performed the Effort Expenditure for Reward Task (EEfRT), which defines the motivational level of each participant by the effort that participants agree to do in function of reward magnitudes and probabilities to receive these reward (10, 50, and 90%). The completion of both tasks allowed for the exploration of the relationship between the motivational level and decision-making abilities. The EEfRT was adapted to electroencephalography (EEG) recordings to explore how motivation could influence reward experience. Behavioral results showed no difference in EEfRT performances on the whole task between the two groups' performances on the IGT. However, there was a negative correlation between the difficulty to develop an optimal strategy on the IGT and the percentage of difficult choices at the 90% condition on the EEfRT. Each probability condition has been previously associated to different motivational and emotional states, with the 90% condition associated to the reward sensitivity. This behavioral result leads to the hypothesis that reward sensitivity may induce an inability to develop an optimal strategy on the IGT. Group analysis demonstrated that only the undecided group showed a P300 during the processing of the outcome, whereas the favorable group showed a blunted P300. Similarly, there was a negative correlation between the P300 amplitude and the ability to develop an optimal strategy on the IGT. In conclusion, behavioral and neuronal data provides evidence that the propensity to focus only on the immediate outcomes is related to the development of an inefficient strategy on the IGT, without influence of motivation.

Effect of transcranial direct current stimulation on sports performance for two profiles of athletes (power and endurance) (COMPETE): a protocol for a randomised, crossover, double blind, controlled exploratory trial.

BACKGROUND: Transcranial direct current stimulation (tDCS) is promising for improving motor and cognitive performance. Nevertheless, its mechanisms of action are unclear and need to be better characterised according to the stimulated brain area and the type of exercise performed. METHODS/DESIGN: This is a double-blind crossover study, organised into two parts: the first is to assess the effects of tDCS on explosive performance (jump task) and the second is to assess the effects on endurance performance (cycling time trial task). Participants, who are recreationally active or athletes (parkour practitioners, cyclists), will receive two active tDCS sessions (over the left dorsolateral prefrontal cortex and right motor cortex) and one sham tDCS session (part A), or two sequences (one active and one sham) of two daily tDCS sessions over 5 days (part B). Motor and cognitive performance will be compared before and after tDCS sessions (part A), and before and after the first session, after the last session and at day 12 and day 30 of each tDCS sequence (part B). DISCUSSION: This study investigates the acute and repeated effects of tDCS on the motor and cognitive performance of healthy subjects. It will try to evaluate if tDCS could be considered as a neuroenhancement technology according to the physical task investigated (endurance versus explosive). TRIAL REGISTRATION: ClinicalTrials.gov, NCT03937115. Registered on 3 May 2019; retrospectively registered.

Event-Related Potentials (ERP) Indices of Motivation during the Effort Expenditure for Reward Task.

Dynamic and temporal facets of the various constructs that comprise motivation remain to be explored. Here, we adapted the Effort Expenditure for Reward Task, a well-known laboratory task used to evaluate motivation, to study the event-related potentials associated with reward processing. The Stimulus Preceding Negativity (SPN) and the P300 were utilized as motivation indicators with high density electroencephalography. The SPN was found to be more negative for difficult choices compared to easy choices, suggesting a greater level of motivation, at a neurophysiological level. The insula, a structure previously associated with both effort discounting and prediction error, was concomitantly activated during the generation of the SPN. Processing a gain significantly altered the amplitude of the P300 compared to an absence of gain, particularly on centroparietal electrodes. One of the generators of the P300 was located on the vmPFC, a cerebral structure involved in the choice between two positive results and their predictions, during loss processing. Both the SPN and the P300 appear to be reliable neural markers of motivation. We postulate that the SPN represents the strength of the motivational level, while the P300 represents the impact of motivation on updating memories of the feedback.

Can transcranial direct current stimulation (tDCS) improve impulsivity in healthy and psychiatric adult populations? A systematic review.

Impulsivity is a multidimensional phenomenon that remains hard to define. It compounds the core pathological construct of many neuropsychiatric illnesses, and despite its close relation to suicide risk, it currently has no specific treatment. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique whose application results in cognitive function improvement, both in healthy and psychiatric populations. Following PRISMA recommendations, a systematic review of the literature concerning tDCS's effects on impulsive behaviour was performed using the PubMed database. The research was based on the combination of the keyword 'tDCS' with 'impulsivity', 'response inhibition', 'risk-taking', 'planning', 'delay discounting' or 'craving'. The initial search yielded 309 articles, 92 of which were included. Seventy-four papers demonstrated improvement in task performance related to impulsivity in both healthy and clinical adult populations. However, results were often inconsistent. The conditions associated with improvement, such as tDCS parameters and other aspects that may influence tDCS's outcomes, are discussed. The overall effects of tDCS on impulsivity are promising. Yet further research is required to develop a more comprehensive understanding of impulsivity, allowing for a more accurate assessment of its behavioural outcomes as well as a definition of tDCS therapeutic protocols for impulsive disorders.

Modelling decision-making under uncertainty: A direct comparison study between human and mouse gambling data.

Decision-making is a conserved evolutionary process enabling us to choose one option among several alternatives, and relies on reward and cognitive control systems. The Iowa Gambling Task allows the assessment of human decision-making under uncertainty by presenting four card decks with various cost-benefit probabilities. Participants seek to maximise their monetary gain by developing long-term optimal-choice strategies. Animal versions have been adapted with nutritional rewards, but interspecies data comparisons are scarce. Our study directly compares the non-pathological decision-making performance between humans and wild-type C57BL/6 mice. Human participants completed an electronic Iowa Gambling Task version, while mice a maze-based adaptation with four arms baited in a probabilistic way. Our data shows closely matching performance between both species with similar patterns of choice behaviours. However, mice showed a faster learning rate than humans. Moreover, both populations were clustered into good, intermediate and poor decision-making categories with similar proportions. Remarkably, mice characterised as good decision-makers behaved the same as humans of the same category, but slight differences among species are evident for the other two subpopulations. Overall, our direct comparative study confirms the good face validity of the rodent gambling task. Extended behavioural characterisation and pathological animal models should help strengthen its construct validity and disentangle the determinants in animals and humans decision-making.

Behavioral and Electrophysiological Arguments in Favor of a Relationship between Impulsivity, Risk-Taking, and Success on the Iowa Gambling Task.

The aim of the present study was to investigate the relationship between trait impulsivity, risk-taking, and decision-making performance. We recruited 20 healthy participants who performed the Iowa Gambling Task (IGT) and the Balloon Analog Risk Task (BART) to measure decision-making and risk-taking. The impulsivity was measured by the Barratt Impulsiveness Scale. Resting-state neural activity was recorded to explore whether brain oscillatory rhythms provide important information about the dispositional trait of impulsivity. We found a significant correlation between the ability to develop a successful strategy and the propensity to take more risks in the first trials of the BART. Risk-taking was negatively correlated with cognitive impulsivity in participants who were unable to develop a successful strategy. Neither risk-taking nor decision-making was correlated with cortical asymmetry. In a more exploratory approach, the group was sub-divided in function of participants' performances at the IGT. We found that the group who developed a successful strategy at the IGT was more prone to risk, whereas the group who failed showed a greater cognitive impulsivity. These results emphasize the need for individuals to explore their environment to develop a successful strategy in uncertain situations, which may not be possible without taking risks.

Effects of High Frequency Repetitive Transcranial Magnetic Stimulation (HF-rTMS) on Delay Discounting in Major Depressive Disorder: An Open-Label Uncontrolled Pilot Study.

BACKGROUND: Delay discounting (DD) refers to the decrease of a present subjective value of a future reward as the delay of its delivery increases. Major depressive disorder (MDD), besides core emotional and physical symptoms, involves difficulties in reward processing. Depressed patients often display greater temporal discounting rates than healthy subjects. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique applied in several countries to adult patients with treatment resistant depression. Studies suggest that this technique can be used to modulate DD, but no trial has assessed its effects on depressed patients. METHODS: In this open-label uncontrolled trial, 20 patients diagnosed with MDD and at least stage II treatment resistance criteria underwent 20 HF-rTMS sessions over the dorsolateral prefrontal cortex (dlPFC; 10 Hz, 110% MT, 20 min). Pre-post treatment DD rates were compared. Effects on impulsivity, personality factors, and depressive symptoms were also evaluated. RESULTS: No significant effect of HF-rTMS over the left dlPFC on DD of depressed individuals was observed, although rates seemed to increase after sessions. However, treatment resulted in significant improvement on cognitive impulsivity and depressive symptoms, and was well-tolerated. CONCLUSION: Despite the limitations involved, this pilot study allows preliminary evaluation of HF-rTMS effects on DD in MDD, providing substrate for further research.

Efficacy of transcranial direct current stimulation in reducing impulsivity in borderline personality disorder (TIMBER): study protocol of a randomized controlled clinical trial.

BACKGROUND: Impulsivity is a core feature of borderline personality disorder (BPD) and is closely related to suicide risk and destructive and aggressive behaviors. Although transcranial direct current stimulation (tDCS) has shown its promising effects as an intervention to modulate impulsivity, no study has explored its potential regarding BPD. METHODS/DESIGN: This is a multicenter, crossover, double-blind study comparing active versus sham tDCS (2 mA, 30 min), applied over the dorsolateral prefrontal cortex for five consecutive days in 50 BPD patients. Participants will be assessed for impulsivity, depressive symptoms, and suicide risk. The main efficacy criteria on reduction of impulsivity will be the amplitude variation of one specific evoked potential detected by electroencephalography (EEG) during the balloon analogue risk task. Baseline measures will be compared to scores obtained immediately after sessions, then 12 and 30 days later. DISCUSSION: This study investigates the safety and effects of tDCS, which may have a significant impact on impulsivity in patients with BPD and may be useful to reduce risky behaviors. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03498937 . Registered on 17 April 2018.

Evidence for a neural signature of musical preference during silence.

One of the most basic and person-specific affective responses to music is liking. The present investigation sought to determine whether liking was preserved during spontaneous auditory imagery. To this purpose, we inserted two-second silent intervals into liked and disliked songs, a method known to automatically recreate a mental image of these songs. Neural correlates of musical preference were measured by high-density electroencephalography in twenty subjects who had to listen to a set of five pre-selected unknown songs the same number of times for two weeks. Time frequency analysis of the two most liked and the two most disliked songs confirmed the presence of neural responses related to liking. At the beginning of silent intervals (400-900 ms and 1000-1300 ms), significant differences in theta activity were originating from the inferior frontal and superior temporal gyrus. These two brain structures are known to work together to process various aspects of music and are also activated when measuring liking while listening to music. At the end of silent intervals (1400-1900 ms), significant alpha activity differences originating from the insula were observed, whose exact role remains to be explored. Although exposure was controlled for liked and disliked songs, liked songs were rated as more familiar, underlying the strong relationship that exists between liking, exposure, and familiarity.

Saccadic Eye Movements and Attentional Control in Alzheimer's Disease.

OBJECTIVE: Several studies have demonstrated saccadic eye movement (SEM) abnormalities in Alzheimer's disease (AD) when patients performed prosaccade (PS) and antisaccade (AS) tasks. Some studies have also showed that SEM abnormalities were correlated with dementia rating tests such as the Mini Mental State Evaluation (MMSE). Therefore, it has been suggested that SEMs could provide useful information for diagnosis. However, little is known about predictive saccades (PreS)-saccades triggered before or very quickly after stimuli appearance-and their relationships with cognition in AD. Here, we aimed to examine the relationships between our usual dementia screening tests and SEM parameters in PS, AS, and also PreS task. METHOD: We compared SEMs in 20 patients suffering from AD and in 35 healthy older adults (OA) in PS, AS, and PreS task. All participants also completed a neuropsychological evaluation. RESULTS: We showed that AD patients had higher latency and latency variability regardless the tasks, and also higher AS cost, in comparison with OA. Moreover, AD patients made more uncorrected AS and took more time-to-correct incorrect AS. In PreS task, AD patients showed higher gain and gain variability than OA when they made anticipated saccades. Close relationships were found between the majority of SEM variables in PS, AS, and PreS tasks and dementia screening tests, especially the MMSE and episodic memory measures. CONCLUSION: Our findings, in agreement with previous studies, demonstrated that AD affects several SEM parameters. SEM abnormalities may reflect selective and executive-attention impairments in AD.

Left Prefrontal Repetitive Transcranial Magnetic Stimulation in a Logopenic Variant of Primary Progressive Aphasia: A Case Report.

BACKGROUND/AIMS: High frequency repetitive transcranial magnetic stimulation (hf-rTMS) improves language skills in Alzheimer's disease (AD). We report the use of hf-rTMS in a patient with logopenic primary progressive aphasia (LPPA) due to AD. METHOD: hf-rTMS was applied to the left dorsolateral prefrontal cortex of a LPPA patient. Cerebral perfusion, neuropsychological and linguistic performances were evaluated before and 1 month after hf-rTMS. RESULTS: The tolerance was good. Improvements on linguistic (fluency, naming, lesser paraphasia) and cognitive skills (Mini Mental State Examination, verbal memory free recall, speed processing) and cerebral perfusion were observed. CONCLUSION: hf-rTMS can be used in LPPA patients. A procognitive effect persisting several weeks after stimulation in LPPA patients was suggested and should therefore be evaluated in a clinical trial as an adjunctive therapeutic tool.