Evidence map›Paper›PMID 30227895›Full record

ArticleAlzheimer's research & therapy2018

The impact of transcranial magnetic stimulation on diagnostic confidence in patients with Alzheimer disease.

Alberto Benussi, Antonella Alberici, Clarissa Ferrari, Valentina Cantoni, Valentina Dell'Era, Rosanna Turrone, Maria Sofia Cotelli, Giuliano Binetti, Barbara Paghera, Giacomo Koch and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Alzheimer's research & therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.

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  8. Clinical diagnostic utility of transcranial magnetic stimulation in neurological disorders. Updated report of an IFCN committee.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2023
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  19. Cortical Inhibitory Imbalance in Functional Paralysis.Frontiers in human neuroscience · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Alberto BenussiNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Antonella AlbericiNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Clarissa FerrariIRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Valentina CantoniNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Valentina Dell'EraNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Rosanna TurroneNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Maria Sofia CotelliNeurology Unit, Ospedale Vallecamonica, Esine, Brescia, Italy.
Giuliano BinettiIRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Barbara PagheraNuclear Medicine Unit, Spedali Civili Brescia, Brescia, Italy.
Giacomo KochNon Invasive Brain Stimulation Unit, IRCCS Santa Lucia Foundation, Rome, Italy.
Alessandro PadovaniNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Barbara BorroniNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. bborroni@inwind.it.ORCID 0000-0001-9340-9814
University of Brescia · ITCentro San Giovanni di Dio Fatebenefratelli · ITAzienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia · ITPoliclinico Tor Vergata · ITUniversity of Florence · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCholinergic dysfunction is a key abnormality in Alzheimer disease (AD) that can be detected in vivo with transcranial magnetic stimulation (TMS) protocols. Although TMS has clearly demonstrated analytical validity, its clinical utility is still debated. In the present study, we evaluated the incremental diagnostic value, expressed in terms of diagnostic confidence of Alzheimer disease (DCAD; range 0-100), of TMS measures in addition to the routine clinical diagnostic assessment in patients evaluated for cognitive impairment as compared with validated biomarkers of amyloidosis.

methodsOne hundred twenty patients with dementia were included and scored in terms of DCAD in a three-step assessment based on (1) demographic, clinical, and neuropsychological evaluations (clinical work-up); (2) clinical work-up plus amyloid markers (cerebrospinal fluid or amyloid positron emission tomographic imaging); and (3) clinical work-up plus TMS intracortical connectivity measures. Two blinded neurologists were asked to review the diagnosis and diagnostic confidence at each step.

resultsTMS measures increased the discrimination of DCAD in two clusters (AD-like vs FTD-like) when added to the clinical and neuropsychological evaluations with levels comparable to established biomarkers of brain amyloidosis (cluster distance of 55.1 for clinical work-up alone, 76.0 for clinical work-up plus amyloid markers, 80.0 for clinical work-up plus TMS). Classification accuracy for the "gold standard" diagnosis (dichotomous - AD vs FTD - variable) evaluated in the three-step assessment, expressed as AUC, increased from 0.82 (clinical work-up alone) to 0.98 (clinical work-up plus TMS) and to 0.99 (clinical work-up plus amyloidosis markers).

conclusionsTMS in addition to routine assessment in patients with dementia has a significant effect on diagnosis and diagnostic confidence that is comparable to well-established amyloidosis biomarkers.

Indexed as

Transcranial Magnetic StimulationAgedAlzheimer DiseaseAmyloidosisBiomarkersBrainFemaleHumansMaleMiddle AgedNeuropsychological TestsPositron-Emission TomographySensitivity and SpecificityBiomarkersAlzheimer diseaseConfidenceDiagnosisFrontotemporal dementiaPET amyloidTranscranial magnetic stimulation

Identifiers

PMID30227895
PMCPMC6145195
OpenAlexW2890619993

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.