Diagnosis of mild cognitive impairment due to Alzheimer's disease with transcranial magnetic stimulation

Alessandro Padovani, Alberto Benussi, Valentina Cantoni, Valentina Dell'Era, Maria Sofia Cotelli, Salvatore Caratozzolo, Rosanna Turrone, Luca Rozzini, Antonella Alberici, Daniele Altomare, Alessandro Depari, Alessandra Flammini, Giovanni B. Frisoni, Barbara Borroni

Research output: Contribution to journalArticlepeer-review


Background: Considering the increasing evidence that disease-modifying treatments for Alzheimer's disease (AD) must be administered early in the disease course, the development of diagnostic tools capable of accurately identifying AD at early disease stages has become a crucial target. In this view, transcranial magnetic stimulation (TMS) has become an effective tool to discriminate between different forms of neurodegenerative dementia. Objective: To determine whether a TMS multi-paradigm approach can be used to correctly identify mild cognitive impairment (MCI) due to AD (AD MCI). Methods: A sample of 69 subjects with MCI were included and classified as AD MCI or MCI unlikely due to AD (non-AD MCI) based on 1) extensive neurological and neuropsychological evaluation, 2) MRI imaging, and 3) cerebrospinal fluid analysis or/and amyloid PET imaging. A paired-pulse TMS multi-paradigm approach assessing short interval intracortical inhibition-facilitation (SICI-ICF), dependent on GABAergic and glutamatergic intracortical circuits, respectively, and short latency afferent inhibition (SAI), dependent on cholinergic circuits, was performed. Results: We observed a significant impairment of SAI and unimpaired SICI and ICF in AD MCI as compared to non-AD MCI. According to ROC curve analysis, the SICI-ICF / SAI index differentiated AD MCI from non-AD MCI with a specificity of 87.9% and a sensitivity of 94.4%. Conclusions: The assessment of intracortical connectivity with TMS could aid in the characterization of MCI subtypes, correctly identifying AD pathophysiology. TMS can be proposed as an adjunctive, non-invasive, inexpensive, and time-saving screening tool in MCI differential diagnosis.

Original languageEnglish
Pages (from-to)221-230
Number of pages10
JournalJournal of Alzheimer's Disease
Issue number1
Publication statusPublished - Jan 1 2018


  • Alzheimer's disease
  • dementia
  • mild cognitive impairment
  • short interval intracortical inhibition
  • short latency afferent inhibition
  • transcranial magnetic stimulation

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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