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In different cognitive disorders, including VCI, transcranial magnetic stimulation (TMS) can be exploited as a noninvasive tool able to evaluate in vivo the cortical excitability, the propension to undergo neural plastic phenomena, and the underlying transmission pathways. Overall, TMS in VCI revealed enhanced cortical excitability and synaptic plasticity that seem to correlate with the disease process and progression. In some patients, such plasticity may be considered as an adaptive response to disease progression, thus allowing the preservation of motor programming and execution. Recent findings also point out the possibility to employ TMS to predict cognitive deterioration in the so-called \u201cbrains at risk\u201d for dementia, which may be those patients who benefit more of disease-modifying drugs and rehabilitative or neuromodulatory approaches, such as those based on repetitive TMS (rTMS). Finally, TMS can be exploited to select the responders to specific drugs in the attempt to maximize the response and to restore maladaptive plasticity. While no single TMS index owns enough specificity, a panel of TMS-derived measures can support VCI diagnosis and identify early markers of progression into dementia. This work reviews all TMS and rTMS studies on VCI. The aim is to evaluate how cortical excitability, plasticity, and connectivity interact in the pathophysiology of the impairment and to provide a translational perspective towards novel treatments of these patients. Current pitfalls and limitations of both studies and techniques are also discussed, together with possible solutions and future research agenda.<\/jats:p>","DOI":"10.1155\/2020\/8820881","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T15:05:07Z","timestamp":1603897507000},"page":"1-17","source":"Crossref","is-referenced-by-count":52,"title":["Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9072-4971","authenticated-orcid":true,"given":"Mariagiovanna","family":"Cantone","sequence":"first","affiliation":[{"name":"Department of Neurology, Sant\u2019Elia Hospital, ASP Caltanissetta, Caltanissetta 93100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5659-662X","authenticated-orcid":true,"given":"Giuseppe","family":"Lanza","sequence":"additional","affiliation":[{"name":"Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy"},{"name":"Department of Neurology IC, Oasi Research Institute\u2013IRCCS, Troina 94108, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Fisicaro","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Pennisi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Bella","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania 95123, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Di Lazzaro","sequence":"additional","affiliation":[{"name":"Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Universit\u00e0 Campus Bio-Medico di Roma, Rome 00128, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Di Pino","sequence":"additional","affiliation":[{"name":"Research Unit of Neurophysiology and Neuroengineering of Human-Technology Interaction (NeXTlab), Universit\u00e0 Campus Bio-Medico di Roma, Rome 00128, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2004.09.016"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70040-1"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.3"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1097\/01.JGP.0000231780.44684.7e"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2017.09.007"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-190654"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2015.12.015"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-804766-8.00020-0"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1111\/jnp.12039"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-016-0720-5"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2016.01.015"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1997.01830220033006"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/430128"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1590\/1980-57642015dn93000004"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1042\/CS20160607"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2477"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-160087"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.57.11.1071"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2009.5"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh553"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(03)00305-3"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.10.2159"},{"issue":"3","key":"23","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1192\/bjp.bp.107.036756","article-title":"White matter changes and late-life depressive symptoms: longitudinal study","volume":"191","author":"A. 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