The dysfunction of cholinergic neurons is a typical hallmark in Alzheimer's disease (AD). Previous findings demonstrated that high density of cholinergic receptors is found in the thalamus and the cerebellum compared with the cerebral cortex and the hippocampus. We aimed at investigating whether activation of the cerebello-thalamo-cortical pathway by means of cerebellar theta burst stimulation (TBS) could modulate central cholinergic functions evaluated in vivo by using the neurophysiological determination of Short-Latency Afferent Inhibition (SLAI). We tested the SLAI circuit before and after administration of cerebellar continuous TBS (cTBS) in 12 AD patients and in 12 healthy age-matched control subjects (HS). We also investigated potential changes of intracortical circuits of the contralateral primary motor cortex (M1) by assessing short intracortical inhibition (SICI) and intracortical facilitation (ICF). SLAI was decreased in AD patients compared to HS. Cerebellar cTBS partially restored SLAI in AD patients at later inter-stimulus intervals (ISIs), but did not modify SLAI in HS. SICI and ICF did not differ in the two groups and were not modulated by cerebellar cTBS. These results demonstrate that cerebellar magnetic stimulation is likely to affect mechanisms of cortical cholinergic activity, suggesting that the cerebellum may have a direct influence on the cholinergic dysfunction in AD.

Background: Stroke survivors have poor long-term quality of life (QoL), especially in the dimensions of mobility and daily activities. Objectives: We aimed to investigate how clinical variables influence QoL during subacute stroke rehabilitation. Methods: We assessed the evolution of the health-related QoL (HRQoL), the balance skills, the sensory–motor functions, and the ability in the activity of daily living in 25 hospitalized patients (60.6 ± 11.14 years old; 32% female) during a period of 2 months of stroke rehabilitation. We used the Stroke-Specific Quality of Life scale (SSQoL) to assess the HRQoL; the Berg Balance Scale to assess gait and balance functions; the Fugl-Meyer Assessment scale for sensory–motor functions of upper (UE) and lower limb (LE); and the Barthel Index for activity of daily living. All data have been investigated with the repeated-measures analysis of variance before and after normalization. Multiple Regression Analysis (MRA) has been performed on the normalized data and between the normalized data and the demographic characteristics (Gender; Age; Lesion side). Results: A significant improvement was found in all the assessed scales during the time of observation. MRA shows a positive regression between HRQoL and the motor recovery of LE and between HRQoL and the balance skills in 60 days from the stroke (MR = 0.88; respectively: p = 0.004 and p = 0.02). Conclusions: Our result shows that LE motor recovery impacts the QoL more than motor recovery of UE after 60 days of neurorehabilitation. This finding is strengthened by a positive regression between balance skills and QoL.