The investigators will compare cognitition, mood (depression), ADL, and brain structural and functional MRI before and after 4-week transcranial magnetic stimulation in patients with mild to moderate Alzheimer's disease. The investigators also compare the change of cognitition, mood (depression), ADL, and brain structural and functional MRI between TMS group and sham coil group.
Each 16 patients will be allocated to TMS group and sham coil group. Before TMS/sham coil stimulation, the investigators will take fMRI of each patient, and figure out which focus has strongest connectivity to hippocampus among lateral parietal regions of the brain. The investigators will fix the TSM transduced and apply accurate TMS stimulation to the focus using personalized frames. The investigators will make the frame using 3D printing technology. After 4 week- TMS stimulation, the investigators will compare cognitition, mood (depression), ADL, and brain structural and functional MRI beween baseline and after intervention. The investigators also compare the change of cognitition, mood (depression), ADL, and brain structural and functional MRI between TMS group and sham coil group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
* stimulation intensity : motor threshold 100% * stimulation frequency : 1600 pulses for 20 minutes * stimulation duration :for four weaks, 20 minutes/day, 5 days per week (Monday - Friday )
no stimulation Although the sound from device during stimulation is similar, no stimulation is applied.
Samsung Medical Center
Seoul, South Korea
the short term change of K-MMSE score in TMS group
the short term change of K-MMSE (Korean version of mini mental status exam) score in TMS group
Time frame: 4 weeks
the short term change of K-MoCA score in TMS group
the short term change of K-MoCA (Korean version of Montreal cognitive assessment) score in TMS group
Time frame: 4 weeks
the short term change of ADAS-Cog score in TMS group
the short term change of ADAS-Cog(the Alzheimer's disease assessment scale-cognitive subscale) score in TMS group
Time frame: 4 weeks
the short term change of COWAT score in TMS group
the short term change of COWAT(controlled oral word association) score in TMS group
Time frame: 4 weeks
the short term change of Stroop score in TMS group
the short term change of Stroop score in TMS group
Time frame: 4 weeks
the short term change of TMT score in TMS group
the short term change of TMT(trail-making test) score in TMS group
Time frame: 4 weeks
the short term change of RVP score in TMS group
the short term change of RVP(raid visual information processing) score in TMS group
Time frame: 4 weeks
the short term change of SWM score in TMS group
the short term change of SWM (spatial working memory) score in TMS group
Time frame: 4 weeks
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the short term change of PRM score in TMS group
the short term change of PRM(pattern recognition memory) score in TMS group
Time frame: 4 weeks
the long term change of K-MMSE score in TMS group
the long term change of K-MMSE (Korean version of mini mental status exam) score in TMS group
Time frame: 8 weeks
the long term change of K-MoCA score in TMS group
the long term change of K-MoCA (Korean version of Montreal cognitive assessment) score in TMS group
Time frame: 8 weeks
the long term change of ADAS-Cog score in TMS group
the long term change of ADAS-Cog(the Alzheimer's disease assessment scale-cognitive subscale) score in TMS group
Time frame: 8 weeks
the long term change of COWAT score in TMS group
the long term change of COWAT(controlled oral word association) score in TMS group
Time frame: 8 weeks
the long term change of Stroop score in TMS group
the long term change of Stroop score in TMS group
Time frame: 8 weeks
the long term change of TMT score in TMS group
the long term change of TMT(trail-making test) score in TMS group
Time frame: 8 weeks
the long term change of RVP score in TMS group
the long term change of RVP(raid visual information processing) score in TMS group
Time frame: 8 weeks
the long term change of SWM score in TMS group
the long term change of SWM (spatial working memory) score in TMS group
Time frame: 8 weeks
the long term change of PRM score in TMS
the long term change of PRM(pattern recognition memory) score in TMS group
Time frame: 8 weeks
the change of ADL(activity of daily life) in TMS group
the score change of S-IADL(Seoul-Instrumental activities of daily life)
Time frame: 4 weeks
the short term change of mood (depression) in TMS group
the score change of GDS(geriatric depression scale) short form
Time frame: 4 weeks
the long term change of mood (depression) in TMS group
the score change of GDS(geriatric depression scale) short form
Time frame: 8 weeks
the change of brain function in TMS group
the qualititve change of resting functional MRI
Time frame: 4 weeks
the change of brain structure in TMS group
the change of FA (fractional anisotropy) value in DTI (diffusion tensor imaging) analysis
Time frame: 4 weeks
the comparison of short term change of K-MMSE score between TMS group and sham group
the score change of K-MMSE (Korean version of mini mental status exam)
Time frame: 4 weeks
the comparison of short term change of K-MoCA score between TMS group and sham group
the score change of K-MoCA (Korean version of Montreal cognitive assessment)
Time frame: 4 weeks
the comparison of short term change of CDR-SOB between TMS group and sham group
the score change of CDR-SOB (Clinical dementia rating-sum of boxes)
Time frame: 4 weeks
the comparison of short term change of ADAS-Cog between TMS group and sham group
the score change of ADAS-Cog ( the Alzheimer's disease assessment scale-cognitive subscale)
Time frame: 4 weeks
the comparison of short term change of COWAT score between TMS group and sham group
the score change of COWAT(controlled oral word association) score
Time frame: 4 weeks
the comparison of short term change of Stroop test score between TMS group and sham group
the score change of Stroop test score
Time frame: 4 weeks
the comparison of short term change of TMT between TMS group and sham group
the score change of TMT (trail making test)
Time frame: 4 weeks
the comparison of short term change of RVP score between TMS group and sham group
the score change of RVP(raid visual information processing) score
Time frame: 4 weeks
the comparison of short term change of SWM between TMS group and sham group
the score change of SWM (spatial working memory) score
Time frame: 4 weeks
the comparison of short term change of PRM between TMS group and sham group
the score change of PRM(pattern recognition memory) score
Time frame: 4 weeks
the comparison of change of K-MMSE between TMS group and sham group
the score change of K-MMSE(Korean version of mini mental status exam)
Time frame: 8 weeks
the comparison of long term change of K-MoCA between TMS group and sham group
the score change of K-MoCA (Korean version of Montreal cognitive assessment)
Time frame: 8 weeks
the comparison of long term change of CDR-SOB between TMS group and sham group
the score change of CDR-SOB(Clinical dementia rating-sum of boxes)
Time frame: 8 weeks
the comparison of long term change of ADAS-Cog between TMS group and sham group
the score change of ADAS-Cog ( the Alzheimer's disease assessment scale-cognitive subscale)
Time frame: 8 weeks
the comparison of long term change of COWAT score between TMS group and sham group
the score change of COWAT(controlled oral word association) score
Time frame: 8 weeks
the comparison of long term change of stroop test score between TMS group and sham group
the score change of stroop test score
Time frame: 8 weeks
the comparison of long term change of TMT score between TMS group and sham group
the score change of TMT(trail making test)
Time frame: 8 weeks
the comparison of long term change of RVP score between TMS group and sham group
the score change of RVP(raid visual information processing)
Time frame: 8 weeks
the comparison of long term change of SWM score between TMS group and sham group
the score change of SWM (spatial working memory) score
Time frame: 8 weeks
the comparison of long term change of cognitive function between TMS group and sham group
the score change of PRM(pattern recognition memory) score
Time frame: 8 weeks
the comparison of short term change of mood (depression) between TMS group and sham group
the score change of GDS (geriatric depression scale) short form
Time frame: 4 weeks
the comparison of long term change of mood (depression) between TMS group and sham group
the score change of GDS (geriatric depression scale) short form
Time frame: 8 weeks
the comparison of short term change of ADL between TMS group and sham group
the score change of S-IADL(Seoul instrumental activity of daily life )
Time frame: 4 weeks
the comparison of long term change of ADL between TMS group and sham group
the score change of S-IADL(Seoul instrumental activity of daily life )
Time frame: 8 weeks
the comparison of change of resting fMRI between TMS group and sham group
the qualititve change of resting fMRI
Time frame: 4 weeks
the comparison of change of FA value between TMS group and sham group
the change of FA(fractional anisotropy) value in DTI(diffusion tensor imaging) analysis
Time frame: 4 weeks