Does repetitive transcranial magnetic stimulation improve cognitive function in age‐related neurodegenerative diseases? A systematic review and meta‐analysis

Abstract

ObjectiveHigh‐frequency, repetitive transcranial magnetic stimulation (rTMS) targeted over the dorsolateral prefrontal cortex (DLPFC) is widely used in research to promote neuroplasticity and cognitive enhancement. RTMS is a promising intervention to tackle cognitive decline in people with age‐related neurodegenerative diseases. However, there is currently no systematic evidence examining the effects of DLPFC‐targeted, high‐frequency rTMS on cognitive function in this population. The aim of this systematic review was to evaluate the efficacy and moderators of this treatment intervention.MethodsA comprehensive literature search of five electronic databases was performed to identify articles published before October, 2022. Following PRISMA guidelines, the identified articles were screened, data was extracted, and the methodological quality was assessed using the Cochrane tool, Risk of Bias 2. Meta‐analyses were performed using R Studio (v.4.1.2).ResultsSixteen studies involving 474 participants met the inclusion criteria, of which 8 studies measured global cognitive function. The results from the random‐effects meta‐analysis showed rTMS significantly improved global cognitive function relative to control groups shown by a large, significant effect size (g = 1.39, 95% CI, 0.34–2.43; p = 0.017). No significant effects were found between subgroups or for individual cognitive domains.ConclusionsHigh‐frequency rTMS, targeted over the DLPFC, appears to improve global cognitive function in people with age‐related neurodegenerative diseases. However, these results should be interpreted with caution due to the small number of studies included, and high between‐study heterogeneity.

Effect of high-frequency repetitive transcranial magnetic stimulation on cognitive impairment in WD patients based on inverse probability weighting of propensity scores

“…The observation of patients with cognitive impairment after stroke showed that TMS combined with cognitive training had a positive effect on the overall cognition, executive function and working memory of patients ( Gao et al, 2023 ). A meta-analysis suggested that high-frequency TMS in the DLPFC can improve the overall cognitive function of patients with age-related neurodegenerative diseases ( Miller et al, 2023 ). For patients with ADHD, rTMS can effectively improve sustained attention, processing speed and overall cognitive function ( Chen et al, 2023 ).…”

The influence of sleep disorders on perioperative neurocognitive disorders among the elderly: A narrative review

“…Meta‐analysis found that rTMS targeting the DLPFC could enhance cognitive function in patients with age‐related neurodegenerative diseases. 132 High‐frequency rTMS over the left DLPFC and low‐frequency rTMS over the right DLPFC have been found to improve memory function in patients with MCI and AD, while high‐frequency rTMS over the right inferior frontal gyrus enhanced executive function. 133 Different brain regions targeted by rTMS can produce varying effects.…”

Improvement of working memory in older adults with mild cognitive impairment after repetitive transcranial magnetic stimulation – a randomized controlled pilot study

“…These results are in line with a 2023 literature review on noninvasive brain stimulation in Primary Progressive Aphasia by Papanikolau ( 19 ), which points toward the application of rTMS having a positive effect in improving symptoms, such as verb production, action naming, phonemic-verbal fluency, grammatical comprehension, written spelling, and semantic features. On the contrary, the results from a 2023 random-effects meta-analysis by A. Miller et al ( 20 ) demonstrated that rTMS significantly improved global cognitive function relative to control groups ( p = 0.017), however no significant effects were found for individual cognitive domains. Discrepancies regarding cognitive training are also evident, as some studies report its reinforcing effect on stimulation efficacy ( 21 ), while others show that an enhanced synergistic effect does not occur when both interventions are used simultaneously ( 22 ).…”