High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) impacts activities of daily living of patients with post-stroke cognitive impairment: a systematic review and meta-analysis

Chen, Xin; Guo, Jiaying; Lyu, Zecai; Xiu, Huoqin; Hou, Yufei; Tu, Shuzhen

doi:10.1007/s10072-023-06779-9

Cited by 10 publications

(10 citation statements)

References 33 publications

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“…The vital entries reported as missing in large numbers are entry 2 (41%), entry 7 (0%), entry 13 (12%), and entry 15 (41%). The following were the primary causes: (1) only seven ( 36–38 , 40 , 43 , 46 , 47 ) articles were numbered and registered in the program before the evaluation; (2) the reasons for the exclusion list are not provided in all the articles; (3) only two ( 40 , 46 ) articles considered the risk of study bias when discussing or analyzing the results of each study; (4) all articles were searched without consulting experts in the relevant fields; and (5) 10 ( 31 , 33 , 36 , 39–44 , 47 ) articles do not describe the likelihood of the existence of publication bias in the small-sample studies and the severity of their impacts. The non-vital entries reported as missing in large numbers are entry 3 (0%), entry 10 (0%), entry 12 (29%), and entry 14 (47%).…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen articles had a score ranging from 5 to 11. Among them, three ( 33 , 42 , 44 ) studies scored 5, one ( 31 ) literature scored 6, one ( 41 ) literature scored 6.5, four ( 35 , 39 , 43 , 45 ) articles scored 7, one ( 34 ) literature scored 8, one ( 37 ) literature scored 9, three ( 32 , 36 , 40 ) articles scored 10, and three ( 38 , 46 , 47 ) articles scored 11. Refer to Table 2 for details.…”

Section: Resultsmentioning

confidence: 99%

“…No perfect scores were recorded, with only one ( 33 ) article scoring below 15. Thirteen ( 31 , 34–37 , 39–44 , 46 , 47 ) articles reported scores from 15 to 21, and four ( 32 , 38 , 45 ) articles reported scores from 21 to 27. Refer to Table 2 for details.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of repetitive transcranial magnetic stimulation in post-stroke cognitive impairment: an overview of systematic reviews

Zhang,

Gao,

Wang

et al. 2024

Front. Neurol.

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ObjectiveThe reliability of clinical evidence depends on high-quality meta-analyses/ systematic reviews (MAs/SRs). However, there has been no assessment of the quality of MAs/SRs for repetitive transcranial magnetic stimulation (rTMS) in post-stroke cognitive impairment (PSCI), both nationally and internationally. This article seeks to use radar plotting to visually present the quality of MAs/SRs on rTMS for improving cognitive function in PSCI, aiming to offer an intuitive foundation for clinical research.MethodsEight Chinese or English databases were systematically searched to collect comprehensive literature, and the retrieval time ranged from inception to 26 March 2024. Literature ranking was calculated using six dimensions: publication year, design type, AMSTAR-2 score, PRISMA score, publication bias, and homogeneity. Finally, radar plots were drafted to present a multivariate literature evaluation. The GRADE tool assessed the strength of evidence for the outcome indicators included in the MAs/SRs.ResultsThe 17 articles included had average scores of 12.29, 17, 9.88, 9.71, 12.88, and 12.76 for each dimension. The radar plot showed that an article published in 2023 had the highest rank and a large radar plot area, while an article published in 2021 had the lowest rank and a small radar plot area. The GRADE tool evaluation revealed that 51 pieces of evidence were of very low quality, 67 were of low quality, 12 were of moderate quality, and only one was of high quality.ConclusionThe average rank score of literature ranged from 8.50 to 17, with higher rankings indicating greater significance in literature reference. Variations in literature quality were attributed to inadequate study planning, irregular literature search and screening, insufficient description of inclusion criteria for studies, and inadequate consideration of bias risk in the included studies. Most MAs/SRs indicated that rTMS was more effective than the control group in enhancing the global cognitive function and activities of daily living in PSCI patients. However, the overall quality of the literature was generally low and needs validation from future high-quality evidence.Systematic review registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42023491280.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Efficacy of repetitive transcranial magnetic stimulation in post-stroke cognitive impairment: an overview of systematic reviews

Zhang,

Gao,

Wang

et al. 2024

Front. Neurol.

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“…There are several possible mechanisms that have been suggested. rTMS can regulate the excitability of the cerebral cortex by altering the frequency of stimulation to specific regions of the brain ( Chen et al, 2023 ). Different frequencies of rTMS have different effects.…”

Section: Discussionmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation for Alzheimer’s disease: an overview of systematic reviews and meta-analysis

Xue,

Li,

Xiao

et al. 2024

Front. Aging Neurosci.

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ObjectiveAlzheimer’s disease (AD) is a prevalent neurodegenerative condition that significantly impacts both individuals and society. This study aims to evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) as a treatment for AD by summarizing the evidence from systematic reviews (SRs) and meta-analyses (MAs).MethodsSRs/MAs of rTMS for AD were collected by searching Embase, Web of Science, Cochrane Library, PubMed, CNKI, VIP, Sino-Med, and Wanfang databases. The search was conducted from database creation to January 23, 2024. Methodological quality, reporting quality and risk of bias were assessed using the Assessing Methodological Quality of Systematic Reviews 2 (AMSTAR-2), Risk of Bias in Systematic Reviews (ROBIS) tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). In addition, the quality of evidence for outcome measures was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).ResultsEight SRs/MAs included in this study met the inclusion criteria. Based on the AMSTAR-2, 4 of the SRs/MA were classified as low quality, while the remaining 4 were deemed to be of very low quality. The PRISMA analysis revealed that out of the 27 items reporting, 16 achieved full reporting (100%). However, there were still some deficiencies in reporting, particularly related to protocol and registration, search strategy, risk of bias, and additional analysis. The ROBIS tool indicated that only 3 SRs/MAs had a low risk of bias. The GRADE assessment indicated that 6 outcomes were of moderate quality (18.75%), 16 were of low quality (50%), and 10 were classified as very low quality (31.25%).ConclusionBased on the evidence collected, rTMS appears to be effective in improving cognitive function in AD patients, although the methodological quality of the SRs/MAs reduces the reliability of the conclusions and the overall quality is low. However, based on the available results, we still support the value of rTMS as an intervention to improve cognitive function in AD. In future studies, it is necessary to confirm the efficacy of rTMS in AD patients and provide more reliable and scientific data to contribute to evidence-based medicine.

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“…In recent years, rTMS has been increasingly applied in clinical to aid cognitive impairment resulting from normal brain aging, mild cognitive impairment (MCI), Alzheimer's disease (AD) and other dementia [37][38][39][40][41][42]. Besides, studies have concerned the effect of rTMS on PSCI other than motor dysfunction after stroke and more reviews of rTMS for PSCI began to published from last year [43,44]. The main theoretical mechanisms of rTMS on PSCI proposed in published clinical studies are based on modulating the excitability of the cortical areas and foster plasticity changes in the cerebral cortex [45].…”

Section: Discussionmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation improves cognitive impairment via the regulation of SDF-1α/CXCR4 axis in rats with ischemic stroke

Li,

Luo,

Deng

et al. 2023

Preprint

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Post-stroke cognitive impairment(PSCI) is a common functional disorder after stroke, but effective therapies are limited. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulatory technique, has been increasingly applied to aid recovery of cognitive function. Despite the wide application of rTMS in clinical researches, the underlying mechanisms remain largely undetermined. This study hypothesized that rTMS improves PSCI by regulating the expressions of SDF-1α/CXCR-4, which of vital significance in cerebral ischemia. An ischemic stroke rat model was established by transient middle cerebral artery occlusion(MCAO). The infarct volume was assessed by T2WI. DTI was conducted to evaluate white matter damage. Behavior tests including modified neurological severity scores(mNSS) and morris water maze(MWM) were performed. Western blotting and Real-Time PCR were performed to measure the expressions of the SDF-1α/CXCR4 in the ipsilateral brain. AMD3100 was used to confirm the effects of SDF-1α/CXCR4 signalling. The results showed that 10 Hz rTMS reduced cerebral infarct volumes and attenuated white matter lesion. Besides, 10 Hz rTMS improved the neurological recovery and cognitive deficits in rats with MCAO. In addition, 10Hz rTMS augmented the expression levels of the SDF-1α/CXCR4 axis after ischemic stroke. Furthermore, rTMS-induced functional improvements were abolished by the CXCR4 inhibitor AMD3100. Our research provides further evidence that 10 Hz rTMS could relieve structural impairments in the ipsilateral brain and alleviate PSCI after ischemic stroke, which was mightly associated with activating of SDF-1α/CXCR4 axis.

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High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) impacts activities of daily living of patients with post-stroke cognitive impairment: a systematic review and meta-analysis

Cited by 10 publications

References 33 publications

Efficacy of repetitive transcranial magnetic stimulation in post-stroke cognitive impairment: an overview of systematic reviews

Efficacy of repetitive transcranial magnetic stimulation in post-stroke cognitive impairment: an overview of systematic reviews

Repetitive transcranial magnetic stimulation for Alzheimer’s disease: an overview of systematic reviews and meta-analysis

Repetitive transcranial magnetic stimulation improves cognitive impairment via the regulation of SDF-1α/CXCR4 axis in rats with ischemic stroke

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