P2‐024: REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION IN PRIMARY PROGRESSIVE APHASIAS AND BEHAVIORAL VARIANT FRONTOTEMPORAL DEMENTIA: A CASE SERIES
Bibliographic record
Abstract
Recent research suggests that repetitive transcranial magnetic stimulation (rTMS) may partially ameliorate language and executive dysfunction in neurodegenerative conditions, including the frontotemporal dementias (FTD). Using an open pilot design, we endeavored to replicate findings of improved action vs. object naming with rTMS of the left dorsolateral prefrontal cortex (DLPFC) in Primary Progressive Aphasias (PPA), extend findings to behavioral variant FTD (bvFTD), and explore effects of rTMS on other language and executive tasks. This case series describes nine, right-handed, participants (4 men and 2 women with PPA, age=67±7 years, education=15±2 years and 3 men with bvFTD, age=68±5 years, education=17±3 years). Participants completed one baseline and two rTMS sessions (one stimulating left DLPFC, the other stimulating right DLPFC). Online (i.e., acute, within-session) performances on action naming, object naming, and a Stroop-like paradigm were compared across sham and active rTMS. Global cognition (Montreal Cognitive Assessment, MOCA) and verbal fluency (Delis-Kaplan Executive Function System, D-KEFS) were assessed at baseline and post-rTMS. Caregivers reported perceived benefits and side-effects within 24-hours of rTMS. Relative improvements were observed in PPA for action naming (4/6 participants improved) and Stroop word reading (5/6 improved) during rTMS of left but not right DLPFC. Both left and right DLPFC rTMS resulted in improved MOCA total scores (6/6 improved) and D-KEFS Letter Fluency (5/6 improved). In bvFTD, relative improvements in action naming (2/3 improved) and object naming (2/3 improved) occurred with rTMS of left DLPFC but not right. Both left and right DLPFC rTMS resulted in improved MOCA total scores (2/3 improved). Caregivers reported improved participant focus or no perceived benefits. Reported side-effects included mild and transient headache, fatigue, and decrease in mental clarity, weakness, anxiety, or trouble sleeping. In this open pilot, rTMS was generally safe and well-tolerated. As hypothesized, left DLPFC rTMS led to online improvements in action naming, with additional gains in online word reading and post-session global cognition for participants with PPA and bvFTD. Randomized controlled trials are needed to better assess the merits of rTMS on cognition and to establish its efficacy as an empirically-supported, non-invasive, treatment of PPAs and bvFTD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".