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A review of transcranial magnetic stimulation in the in vivo functional evaluation of central cholinergic circuits in dementia.
Nardone, R; Golaszewski, S; Ladurner, G; Tezzon, F; Trinka, E;
Dement Geriatr Cogn Disord. 2011; 32(1): 18-25.


Golaszewski Stefan
Nardone Raffaele
Trinka Eugen


Central cholinergic circuits of human brain can be tested non-invasively by coupling electrical peripheral stimulation with transcranial magnetic stimulation (TMS) of the motor cortex. The short-latency afferent inhibition (SAI) is reduced in cholinergic forms of dementia, such as Alzheimer disease (AD) and dementia with Lewy bodies, while it is normal in non-cholinergic forms of dementia, such as frontotemporal dementia. This finding suggests that this method can be used as a non-invasive additional tool for discriminating between cholinergic and non-cholinergic forms of dementia. Interestingly, SAI was also found to be significantly smaller in early AD patients. Identification of SAI abnormalities that occur early in the course of AD will allow earlier diagnosis and treatment with cholinergic drugs. In patients with vascular dementia, SAI responses varied widely; the number of patients with abnormal SAI conceivably reflects the percentage of subjects with a significant cholinergic dysfunction. It has recently been demonstrated that brain microbleeds have an impact on SAI that is independent of the extent of associated white matter changes and ischemic stroke. Since SAI can be increased by acetylcholinesterase inhibitors, TMS may help in identifying the patients who would be suitable for long-term treatment with cholinergic agents.

Useful keywords (using NLM MeSH Indexing)

Afferent Pathways/physiopathology

Alzheimer Disease/physiopathology

Autonomic Pathways/physiopathology

Cerebral Cortex/drug effects

Cerebral Cortex/physiopathology



Dementia, Vascular/physiopathology


Intracranial Hemorrhages/physiopathology

Lewy Body Disease/physiopathology

Muscarinic Antagonists/pharmacology

Parasympathetic Nervous System/physiology*

Transcranial Magnetic Stimulation*

Find related publications in this database (Keywords)

Transcranial magnetic stimulation
Short-latency afferent inhibition
Cholinergic circuits
Alzheimer disease
Dementia with Lewy bodies
Frontotemporal dementia
Vascular dementia