The Posterior Cingulate Cortex Again Forgotten

Koch et al., (2022) 'Repetitive TMS applied to the precuneus stabilizes cognitive status in Alzheimer's disease,' we think that some findings are misunderstood and there are methodological problems. Neuromodulation approaches have been investigated for a long time in the treatment of Alzheimer's dementia. On the other hand, the precuneus region, which is the subject of the research, cannot be considered as an isolated region due to its close neighborhood. Precuneus, it is considered the main center of the default mode network (DMN) like the prefrontal cortex (DLPFC). To date, many DLPFC stimulation studies have been performed with repetitive transcranial magnetic stimulation (rTMS) has been published. It is difficult to evaluate the effect claimed as a result of the research specific to the precuneus region. Theoretically, the effect can be expected with the excitation of any part of the default network. However, unlike previous rTMS studies that stimulated the DLPFC, the authors chose to stimulate the precuneus, the main center of DMN.