This study aimed to investigate the feasibility of repetitive transcranial magnetic stimulation (rTMS) on the occipital lobe in patients with Lewy body dementia.
This is a proof-of-concept study to evaluate the safety and effect of occipital lobe stimulation in patients with Lewy body dementia. Over a period of two weeks, participants will receive rTMS to the primary visual cortex three times a week during visits. For the remaining 10 weeks, maintenance therapy will be administered with rTMS once a week during visits. Efficacy assessments will be conducted on the day of the final stimulation session and again four weeks later.
Over 65 years of age
Meeting the criteria for Probable DLB as proposed in the 2017 DLB diagnostic criteria
Scoring between 0.5 and 1 on the Clinical Dementia Rating Scale (CDR)
If other causes of cognitive impairment are suspected, such as neurosyphilis, hypothyroidism, hyperthyroidism, metabolic encephalopathy, brain tumor, acute cerebral hemorrhage, acute cerebral infarction, previous territorial or strategic cerebral infarction, Wernicke's encephalopathy, or severe white matter hyperintensity detected in hematological tests, brain MRI, etc.
If cooperation for interviews and self-assessment is difficult (e.g., due to hearing impairment, language disorders, severe psychotic conditions)
If there is a history of psychiatric disorders: major affective disorder, schizophrenia, or schizo-affective disorder
If electroencephalography (EEG) cannot be performed
Single group
repetitive transcranial magnetic stimulation
Device10Hz stimulation group will receive 1600 pulses of stimulation in a single session
Sum of boxes of the clinical dementia rating scale
The Clinical Dementia Rating - Sum of Boxes (CDR-SOB) is a quantitative scale used to assess the severity of cognitive and functional impairment in individuals with dementia. It is derived from the Clinical Dementia Rating (CDR), which evaluates six domains: memory, orientation, judgment and problem solving, community affairs, home and hobbies, and personal care. Each domain is rated on a scale from 0 (no impairment) to 3 (severe impairment), and the scores are summed to produce the CDR-SOB, which ranges from 0 to 18. Unlike the global CDR score, the CDR-SOB provides a more sensitive measure of changes in cognitive and functional performance over time, making it especially useful for tracking disease progression in clinical trials and longitudinal studies.
Mini-Mental State Examination
A brief 30-point cognitive screening tool that assesses orientation, memory, attention, calculation, language, and visuospatial skills. 0-30 (higher = better cognition)
Korean version of the Montreal Cognitive Assessment
A more sensitive 30-point cognitive screening test than MMSE, used to detect mild cognitive impairment; assesses memory, executive function, attention, language, and visuospatial skills. 0-30 (higher = better cognition)
Caregiver-Administered Neuropsychiatric Inventory
A caregiver-based questionnaire evaluating behavioral and psychiatric symptoms in dementia across 12 domains (e.g., delusions, hallucinations, agitation). 0-144 (higher = worse symptoms; frequency × severity per domain)
Clinical Global Impression
Assessing overall treatment response. CGI-I: 1-7 (1 = very much improved, 7 = very much worse)
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