{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:42:20Z","timestamp":1792510940998,"version":"4.5.0"},"reference-count":58,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2020,10,13]]},"abstract":"<jats:p>Background: Apathy, a profound loss of motivation, initiation, and goal directed cognition, is a common comorbidity of Alzheimer\u2019s disease (AD). The presence of apathy is associated with rapid progression of AD, long-term impairment, disability, and higher mortality. Pharmacological treatments of apathy are limited. Objective: The primary objective was to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) for apathy in AD. Methods: A randomized, double-blind, parallel-arm, sham-controlled pilot study was conducted in subjects with AD and apathy (N\u200a=\u200a20). Subjects were randomized to rTMS or sham treatment (5 days\/week) for four weeks. Primary outcome, apathy evaluation scale-clinician version (AES-C), and secondary outcome measures, modified-Mini Mental State Examination (3MS), instrumental activities of daily living (IADL), and clinical global impression (CGI), were assessed at baseline and four weeks. Follow-up visits were conducted at 8 and 12 weeks to test the durability of effects of intervention. Results: Mean age was 77.3 (\u00b17.2) years, 80% were Caucasians and 10% were females. After adjusting for baseline, there was a significantly greater improvement in the AES-C with rTMS compared to sham treatment (\u201310.1 (\u201315.9 to \u20134.3); t\u00a0(16)\u00a0\u200a=\u200a\u20133.69; p\u200a=\u200a0.002) at 4 weeks. There was also significantly greater improvement in 3MS (6.9 (1.7 to 12.0); t\u00a0(15)\u00a0\u200a=\u200a2.85; p\u200a=\u200a0.012), IADL (3.4 (1.0 to 5.9); \u03c721\u200a=\u200a7.72; p\u200a=\u200a0.006), CGI-S (1.4 (0.5 to 2.3), t\u00a0(16)\u00a0\u200a=\u200a3.29; p\u200a=\u200a0.005), and CGI-I (\u20132.56 (\u20133.5 to \u20131.6), t\u00a0(17)\u00a0\u200a=\u200a\u20135.72; p\u200a&lt;\u200a0.001) for rTMS compared to the sham at 4 weeks. The effects of rTMS were durable at 12 weeks. Conclusion: rTMS may be safely used in subjects with AD and may improve apathy, function, and some aspects of cognition.<\/jats:p>","DOI":"10.3233\/jad-200640","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T10:13:40Z","timestamp":1599560020000},"page":"1483-1493","source":"Crossref","is-referenced-by-count":60,"title":["Neuromodulation for Apathy in Alzheimer\u2019s Disease: A Double-Blind, Randomized, Sham-Controlled Pilot Study"],"prefix":"10.1177","volume":"77","author":[{"given":"Prasad R.","family":"Padala","sequence":"first","affiliation":[{"name":"Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA"},{"name":"Department of Psychiatry, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA"},{"name":"Department of Geriatrics, UAMS, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia M.","family":"Boozer","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelly Y.","family":"Lensing","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA"},{"name":"Department of Biostatistics, UAMS, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Parkes","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra R.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Dennis","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA"},{"name":"Department of Geriatrics, UAMS, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Caceda","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Stony Brook University Medical Center, Stony Brook, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalpana P.","family":"Padala","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA"},{"name":"Department of Geriatrics, UAMS, Little Rock, AR, 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