Xiaowei Tan, MD, PhD | Institute of Mental Health; Yao Fengyuan, MD; Tor Phern Chern, MD; Goh Shih Ee, MD; Jonathan Lee, MD
Competition Sponsor: Ministry of Health and National Research Foundation of Singapore
Awardee Year: 2025
Emerging evidence suggests that repetitive transcranial magnetic stimulation (rTMS) enhances cognition in patients with mild cognitive impairment (MCI). Accelerated intermittent theta burst stimulation (iTBS), the subtype of rTMS protocols, is promising to treat MCI as it substantially reduces disease burden by shortening the treatment course, but the effectiveness, safety, feasibility, and acceptability of iTBS have not been established.
A total of 30 adults with amnestic MCI will be enrolled in a phase I trial of a single-arm, open-label study of an accelerated iTBS targeting the left dorsolateral prefrontal cortex (five stimulation sessions of 1800 pulses of iTBS/day for five working days). Enrolled participants will complete a neuropsychiatric evaluation toolbox, which includes several memories, mood conditions, daily functional activities, subjective quality of life and other cognitive function tests before and after treatment and being followed up for three months. The primary outcome is the change in the Montreal Cognitive Assessment score immediately after treatment. Participants will also rate possible common side effects during and after treatment.
The findings of this trial will help to examine the treatment effectiveness, feasibility, and safety profile of a novel accelerated iTBS treatment regime among the local aged population to improve cognitive function as well as mood conditions. This intervention might also delay the conversion rate of MCI to dementia and provide preliminary data for a larger scale study with longer-term follow-up to assess the clinical utility of precision and personalized iTBS as a preventive tool for dementia disease.