https://digitalcommons.unmc.edu/emet_posters/1027/thumbnail.jp

Christopher-Hayes, Nicholas

Faller, Carly

Jing, Ran

Murman, Daniel L.

Phatak, Vaishali

Phipps, Connor J.

Rangel, Anthony

Warren, David E.

English

University of Nebraska Medical Center Research: DigitalCommons@UNMC

University of Nebraska Medical Center DigitalCommons@UNMC EMET Projects College of Medicine Students 2021 Effect of Targeted Transcranial Magnetic Stimulation on Hippocampal-Dependent Declarative Memory in Older Adults Carly Faller Ran Jing Nicholas Christopher-Hayes Anthony Rangel Connor J. Phipps See next page for additional authors Follow this and additional works at: https://digitalcommons.unmc.edu/emet_posters  Part of the Medical Education Commons Authors Carly Faller, Ran Jing, Nicholas Christopher-Hayes, Anthony Rangel, Connor J. Phipps, Vaishali Phatak, Daniel L. Murman, and David E. Warren Effect of targeted transcranial magnetic stimulation on hippocampal-dependent declarative memory in older adults Carly Faller, Ran Jing, Nicholas Christopher-Hayes, Anthony Rangel, Connor Phipps, Vaishali Phatak, Daniel L. Murman, David E. Warren Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198• Memory disorders affect patients, caregivers, and health care systems byreducing independence and degrading identity• Healthy aging is related to slow declines in memory and hippocampal atrophy• Pathological aging due to AD is associated with sharp declines in memoryTranscranial Magnetic Stimulation • TMS induces electric current in brain tissue using strong magnetic fields• Stimulation can be excitatory or inhibitory• TMS can only penetrate 3-4 cm beneath skull — no deep structures• Repetitive TMS (rTMS) = stimulation delivered with a Nexstim 5.0 NBS at 20 Hz(2 sec stim, 28 sec pause, 20 min. per day for 5 consecutive days)Specific AimsUsed to measure participant cognitive abilities at baselineAfter rTMS, compare cognitive abilities to baseline abilities and determine if a relationships or improvement exists Methods• Participants drawn from the UNMC Mind Brain Health Registry and the UNMCDONS Memory Disorders Clinic and compensated for their time• Age range from 65-85 years old• Informed consent and screening prior to full enrollment• Screening criteria: MoCA score of >26 in order to continue, confirm rTMS andMRI compatibility by ruling out implanted devices, claustrophobia, history ofseizure, and excessive movement during MRI scanningHypothesis: A 5-day course of excitatory rTMS focused on one part of a targetbrain network will improve the connectivity of that network with associatedimprovements in memory abilities and tested via neuropsychological assessmentand functional neuroimaging with MRINeurocognitive TestingStatus and Future DirectionsEnrollment of healthy younger adults has been closed and completedPreliminary data shows increased recall of more words with history of treatmentwith rTMS (in both younger and older adults)ReferencesAlbert, M. S., DeKosky, S. T., Dickson, D., Dubois, B., Feldman, H. H., Fox, N. C., ... & Snyder, P. J. (2011). The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & dementia: the journal of the Alzheimer's Association, 7(3), 270-279.Freitas, C., Mondragón-Llorca, H., & Pascual-Leone, A. (2011). Noninvasive brain stimulation in Alzheimer's disease: systematic review and perspectives for the future. Experimental gerontology, 46(8), 611-627.Hermiller, M. S., VanHaerents, S., Raij, T., & Voss, J. L. (2018). Frequency-specific noninvasive modulation of memory retrieval and its relationship with hippocampal network connectivity. Hippocampus.Konkel, A., Warren, D.E., Duff, M.C., Tranel, D.N., and Cohen, N.J. (2008). Hippocampal amnesia impairs all manner of relational memory. Front. Hum. Neurosci. 2, 1–15.Wang, J.X., and Voss, J.L. (2015). Long-lasting enhancements of memory and hippocampal-cortical functional connectivity following multiple-day targeted noninvasive stimulation. Hippocampus 25, 877–883.• Restoring memory abilities could lessen debilitating effects of memory loss• Non-invasive transcranial magnetic stimulation (TMS) has been identified as apossible treatment modality for the memory deficits typical of AD• TMS has led to improved memory in healthy young adults but has not yet beenapplied to healthy and non-healthy older adultsBackground(1) Declarative memory will be measured in older participants who are treated withrepetitive TMS (rTMS). It is hypothesized that with rTMS, a significant positivechange will occur in declarative memory performance when compared to thosewho receive placebo (“sham”) stimulation.(2) Specific brain networks related to memory will be measured using MRI in olderadults who are treated with rTMS. It is hypothesized that those administeredrTMS compared to a sham stimulation will show in increase in connectivitywithin brain networks related to memory abilities.ADHealthyLeft: Memory networks in the brain that are connected to the hippocampusConnections from the lateral parietal cortex (targeted brain region) reach thehippocampus and its functional networkHippocampal networks are imperative for storage and retrieval of relationalmemories (targeted cognitive ability)Frequencies >1 Hz increase activity in the stimulated parietal region and itsextended networkLeft: Example of face image used during recall and oralpresentation of associated word after studying 20 differentpairsRight: Objects used inrelational memorytasks that requirehippocampalcontributionsLong-term memory à declarative memory à non-relational vs. relational memoryRelational memory includes: words, events, sequences, routes, and scenesThe hippocampus is necessary for normal relational memory.The research reported on this poster was supported by Great Plains IDeA-CTR, Fremont Area Alzheimer’s Fund, UNMC DONS, and the UNMC MSSRP. The investigators retained full independence in the conduct of this research.Right: A cross correlation matrixfrom a healthy young adultshowing the effects of sham andstimulatory rTMS.

Effect of Targeted Transcranial Magnetic Stimulation on Hippocampal-Dependent Declarative Memory in Older Adults

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Effect of Targeted Transcranial Magnetic Stimulation on Hippocampal-Dependent Declarative Memory in Older Adults

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