{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:24Z","timestamp":1792787304408,"version":"4.5.0"},"reference-count":40,"publisher":"BMJ","issue":"12","funder":[{"name":"Italian Ministry of Health","award":["RF- 2010-2311484"],"award-info":[{"award-number":["RF- 2010-2311484"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the ability of transcranial magnetic stimulation (TMS) in detecting synaptic impairment in patients with\u00a0Alzheimer\u2019s disease (AD) and predicting cognitive decline since the early phases of the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used TMS-based parameters to evaluate long-term potentiation (LTP)-like cortical plasticity and cholinergic activity as measured by short afferent inhibition (SAI) in 60 newly diagnosed patients with\u00a0AD and 30 healthy age-matched subjects (HS). Receiver operating characteristic (ROC) curves were used to assess TMS ability in discriminating patients with\u00a0AD\u00a0from HS. Regression analyses examined the association between TMS-based parameters and cognitive decline. Multivariable regression model revealed the best parameters able to predict disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Area under the\u00a0ROC curve was 0.90 for LTP-like cortical plasticity, indicating an excellent accuracy of this parameter in detecting AD pathology. In contrast, area under the curve was only 0.64 for SAI, indicating a poor diagnostic accuracy. Notably, LTP-like cortical plasticity was a significant predictor of disease progression (p=0.02), while no other neurophysiological, neuropsychological and demographic parameters were associated with cognitive decline. Multivariable analysis then promoted LTP-like cortical plasticity as the best significant predictor of cognitive decline (p=0.01). Finally, LTP-like cortical plasticity was found to be strongly associated with the probability of rapid cognitive decline (delta Mini-Mental State Examination score \u2264\u22124 points at 18 months) (p=0.04); patients with\u00a0AD with lower LTP-like cortical plasticity values showed faster disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TMS-based assessment of LTP-like cortical plasticity could be a viable biomarker to assess synaptic impairment and predict subsequent cognitive decline progression in patients with\u00a0ADs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2017-317879","type":"journal-article","created":{"date-parts":[[2018,7,21]],"date-time":"2018-07-21T12:15:33Z","timestamp":1532175333000},"page":"1237-1242","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":90,"title":["Transcranial magnetic stimulation predicts cognitive decline in patients with\u00a0Alzheimer\u2019s disease"],"prefix":"10.1136","volume":"89","author":[{"given":"Caterina","family":"Motta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Lorenzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Ponzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Concetta","family":"Pellicciari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bonn\u00ec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Picazio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola Biagio","family":"Mercuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Caltagirone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Martorana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6155-9439","authenticated-orcid":false,"given":"Giacomo","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,7,21]]},"reference":[{"key":"2020050722284635000_89.12.1237.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70090-0"},{"key":"2020050722284635000_89.12.1237.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2011.03.005"},{"key":"2020050722284635000_89.12.1237.3","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(199903)45:3<358::AID-ANA12>3.0.CO;2-X"},{"key":"2020050722284635000_89.12.1237.4","doi-asserted-by":"crossref","unstructured":"Blennow K , Zetterberg H . 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