Tms Combined With Tai Chi Effect On Executive Function In Mild Cognitive Impairment Patients

Mild cognitive impairment (MCI), as a neurodegenerative disorder, with a high rate of transition to Alzheimer's disease, finding appropriate interventions to improve cognitive function in MCI patients is urgent. Tai chi (TC) is one of the most representative traditional aerobic exercises in China, believed to reshape brain structure, improve brain function, and elevate overall cognition and memory levels. Transcranial magnetic stimulation (TMS), a non-invasive brain stimulation technique, was widely used in various neurological and neuropsychiatric diseases. However, the therapeutic effects of TC combined with TMS intervention on MCI patients remain unclear at present. PURPOSE: To investigate TMS combined with TC effect on improvement of executive performance and hemodynamic variations of prefrontal cortex in MCI by functional Near-Infrared Spectroscopy (fNIRS). METHODS: This study was a randomized controlled trial. Participants with confirmed diagnosis of MCI (n = 42) were recruited and randomly divided into two groups: (1) incorporating TC exercises and TMS intervention (intervention group: TT group, age: 68.33 ± 6.60 years); (2) incorporating TC exercises only (control group: TC group, age: 66.67 ± 5.95 years). Reaction time (RT), accuracy (ACC) and oxygenation of the prefrontal brain cortex were evaluated at baseline and after 12-weeks of intervention. RESULTS: In the Flanker task, during the incongruent condition there were significant differences between the TT and TC groups in left dorsolateral (L-DLPFC) prefrontal cortex oxygenation (TT group: 11.54 ± 5.98 μM × 10-5; TC group: 6.33 ± 4.24 μM × 10-5; p = 0.005), RT (TT group: 550.28 ± 60.27 ms; TC group: 707.22 ± 82.39 ms; p < 0.001) and ACC (TT group: 93.00 ± 1.00%; TC group: 91.00 ± 1.00%; p < 0.001) after 12-weeks of intervention. And through the intervention there was also a significant difference in the time to complete TMT-B (TT group: 81.22 ± 13.12; TC group: 88.89 ± 6.94; p = 0.035) between the two groups, but no significant differences were found in TMT-A (TT group:47.83 ± 11.62; TC group: 46.50 ± 6.96; p > 0.05). CONCLUSION: The combination of TMS and TC provided additional benefits by enhancing executive function and prefrontal cortex oxygenation in MCI patients over TC alone.