RTMS-INDUCED CHANGES IN COGNITIVE PERFORMANCE AND CORTICAL EXCITABILITY: A CASE STUDY ON BRAIN AGING.

#1248 RTMS-INDUCED CHANGES IN COGNITIVE PERFORMANCE AND CORTICAL EXCITABILITY: A CASE STUDY ON BRAIN AGING Chiara Di Fazio1, Eugenio Scaliti1, Mario Stanziano2, Anna Nigri2, Greta De Michelis2, Marco Tamietto1, Sara Palermo1 1University of Turin, Psychology, Turin, Italy, 2University of Milan, Medicine, Milan, Italy AS37. Neurophysiology Abstract Submission Background and Aims rTMS is a non-invasive technique with growing evidence of efficacy in modulating neurophysiological, affective, and cognitive functions in brain aging. This study assessed rTMS effectiveness in improving cognitive and affective functions by targeting the left DLPFC. Methods The woman underwent rTMS treatment targeting the left DLPFC using neuronavigation. The protocol included 800 pulses per session, at 10 Hz and 120% motor threshold for 36 sessions over 3 months (three per week). Neuropsychological and neurophysiological assessments were conducted at baseline and after 12 weeks, with a follow-up at 6 months to evaluate persistence of possible changes. Additionally, cortical excitability was assessed through motor evoked potentials (MEPs) recorded before and after treatment. Results Following rTMS, the EQ-5D-5L index increased by 0.159, reflecting improved health-related quality of life. Perceived health improved by 10 points, and the FAS score decreased by 6 points, indicating reduced fatigue. Mood (BDI-II) improved by 7 points, becoming subclinical, while anxiety (BAI) decreased by 10 points. Cognitive assessments showed an ACE-R score increase of 5 points, MMSE improvement by 2.5 points, and enhanced TMT scores: Part A by 7.16 seconds (processing speed/attention) and Part B by 4.02 seconds (executive function). Furthermore, MEP amplitude modulation post-treatment suggested adaptive inhibitory processes linked to rTMS efficacy, which was maintened at follow-up measurements at 6 month. Conclusions Results indicate improved cognitive function, reduced fatigue, and mood stabilization, culminating in enhanced quality of life. Targeted rTMS treatment improves TMT performance; changes in TMT scores and cortical excitability’s modulation highlight rTMS’s potential to address age-related cognitive decline.