Integrating repetitive transcranial magnetic stimulation and Mediterranean diet for cognitive and anxiety improvement in early Alzheimer's disease: A case report and literature review

A 52-year-old male with early-stage Alzheimer's disease and long-standing anxiety received 30 repetitive transcranial magnetic stimulation sessions over 8 months and 20-month Mediterranean diet intervention. Neuropsychological assessments [Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Clinical Dementia Rating, Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Pittsburgh Sleep Quality Index) and resting-state electroencephalogram (rsEEG) were conducted at baseline, during treatment, and at 6-month follow-up. After treatment, MoCA and MMSE scores improved by 6 and 5 points; HAMA and HAMD scores declined by 7 and 3 points. rsEEG showed progressive increases in individual alpha peak frequency (8.69 to 10.22 Hz), enhancement of alpha power, and reduction in theta power. Cerebrospinal fluid amyloid-β₄₂ levels also normalized. The patient reported marked mental well-being.