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Transcranial magnetic stimulation of the precuneus enhances memory and neural activity in prodromal Alzheimer's disease
Koch G, Bonnì S, Pellicciari MC, Casula EP, Mancini M, Esposito R, Ponzo V, Picazio S et al.. NeuroImage, 2017-12-19
Topic: Brain proteins, microglia and lab models
Memory loss is one of the first symptoms of typical Alzheimer's disease (AD), for which there are no effective therapies available. The precuneus (PC) has been recently emphasized as a key area for the memory impairment observed in early AD, likely due to disconnection mechanisms within large-scale networks such as the default mode network (DMN). Using a multimodal approach we investigated in a two-week, randomized, sham-controlled, double-blinded trial the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) of the PC on cognition, as measured by the Alzheimer Disease Cooperative Study Preclinical Alzheimer Cognitive Composite in 14 patients with early AD (7 females). TMS combined with electroencephalography (TMS-EEG) was used to detect changes in brain connectivity. We found that rTMS of the PC induced a selective improvement in episodic memory, but not in other cognitive domains. Analysis of TMS-EEG signal revealed an increase of neural activity in patients' PC, an enhancement of brain oscillations in the beta band and a modification of functional connections between the PC and medial frontal areas within the DMN. Our findings show that high-frequency rTMS of the PC is a promising, non-invasive treatment for memory dysfunction in patients at early stages of AD. This clinical improvement is accompanied by modulation of brain connectivity, consistently with the pathophysiological model of brain disconnection in AD.
Key findings
- We found that rTMS of the PC induced a selective improvement in episodic memory, but not in other cognitive domains.
- Analysis of TMS-EEG signal revealed an increase of neural activity in patients' PC, an enhancement of brain oscillations in the beta band and a modification of functional connections between the PC and medial frontal areas within the DMN.
- Our findings show that high-frequency rTMS of the PC is a promising, non-invasive treatment for memory dysfunction in patients at early stages of AD.
Why it matters
In this small two-week trial of 14 patients with early Alzheimer disease, repetitive transcranial magnetic stimulation of the precuneus produced a selective improvement in episodic memory but not other cognitive domains. The findings are preliminary and come from a very small sample.
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Study details
- Participants14
- Evidence strengthHigh
How this study scored 59/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (NeuroImage) |
| Journal's citation record | 4 / 4 | NeuroImage: journal h-index 523 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 1 / 4 | 14 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 370 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 37.0 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 4 / 6 | Cited 9.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 7 other studies in this library |
| Still being cited | 3 / 4 | Cited 140 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Marco Bozzali: h-index 63 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Rome Tor Vergata: institution h-index 778 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29277405) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 59 / 100 | — |
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Read the original
- DOI: 10.1016/j.neuroimage.2017.12.048
- PubMed: 29277405
- Original source →
- Free full text: figshare.com →
Full text: free to read — Unpaywall lists this copy as free to read: the link above (checked 10 Oct 2026).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Koch, G., Bonnì, S., Pellicciari, M. C., Casula, E. P., Mancini, M., Esposito, R., et al. (2018). Transcranial magnetic stimulation of the precuneus enhances memory and neural activity in prodromal Alzheimer's disease. NeuroImage. https://doi.org/10.1016/j.neuroimage.2017.12.048
Vancouver
Koch G, Bonnì S, Pellicciari MC, Casula EP, Mancini M, Esposito R, et al. Transcranial magnetic stimulation of the precuneus enhances memory and neural activity in prodromal Alzheimer's disease. NeuroImage. 2018. doi:10.1016/j.neuroimage.2017.12.048. PMID: 29277405.
BibTeX
@article{koch2018-29277405,
author = {Koch, G. and Bonnì, S. and Pellicciari, M. C. and Casula, E. P. and Mancini, M. and Esposito, R. and Ponzo, V. and Picazio, S. and others},
title = {{Transcranial magnetic stimulation of the precuneus enhances memory and neural activity in prodromal Alzheimer's disease}},
journal = {NeuroImage},
year = {2018},
doi = {10.1016/j.neuroimage.2017.12.048},
pmid = {29277405},
url = {https://doi.org/10.1016/j.neuroimage.2017.12.048}
}
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