AI Article Synopsis
- Transcranial magnetic stimulation (TMS) is a non-invasive treatment showing potential to enhance cognitive abilities in Alzheimer's disease; however, its effectiveness and best practices are still debated.
- A meta-analysis included 21 studies to evaluate TMS protocols for cognitive improvement in mild cognitive impairment (MCI) and Alzheimer's patients, using databases like PubMed and Cochrane.
- Results indicated significant cognitive improvement from real TMS compared to sham treatments, particularly with targeted stimulation of specific brain areas and moderate frequencies (5 Hz and 10 Hz), alongside the suggestion that combining TMS with cognitive training may enhance outcomes even further.
Article Abstract
Introduction: Transcranial magnetic stimulation (TMS) is a non-invasive intervention that holds promise for improving cognitive function in individuals with Alzheimer's disease (AD). However, the effectiveness of this therapy and the optimal TMS parameters has not reached a consensus. The purpose of the meta-analysis was to systematically discern the effectiveness of different components of TMS protocols on cognitive improvement in patients with mild cognitive impairment (MCI) and AD.
Methods: The meta-analysis was preregistered on Prospero (registration number: CRD42022345482). PubMed, Web of Science, Science Direct, and Cochrane Library databases were used to search, screen and identify eligible studies with the following keywords: Transcranial Magnetic Stimulation OR TMS OR theta burst stimulation AND Alzheimer OR Alzheimers OR Alzheimer's OR mild cognitive impairment OR MCI. Randomized controlled trials (RCTs) of participants with accepted standardized diagnostic criteria were searched by two authors independently. The risk of bias was assessed using an adapted Cochrane Risk of Bias tool. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated using the random-effects models. Subgroup analyses were performed to investigate the influential factors.
Results: A total of 21 studies and 25 trials were included in this meta-analysis. The findings revealed a significant overall cognition improvement of real stimulation compared with sham stimulation (short-term effects: SMD, 0.91; 95% CI 0.44-1.38; < 0.01; long-lasting effects: SMD, 0.91; 95% CI 0.27-1.55; < 0.01). Subgroup analysis demonstrated that stimulation of the left dorsolateral prefrontal cortex and bilateral cerebellums, as well as moderate frequency stimulation (5 Hz and 10 Hz) on mild and moderate cognitive impairment patients, were more effective than other TMS protocols. However, the additional application of cognitive training showed no significant improvement.
Conclusion: Cognitive improvement effect of TMS was demonstrated in MCI and AD patients in both short-term assessment and long-lasting outcomes, and the efficiency of TMS is affected by the stimulation frequency, stimulation site, and participant characteristics. Further RCTs are needed to validate the findings of our subgroup analysis.
Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022345482, identifier: CRD42022345482.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389278 | PMC |
| http://dx.doi.org/10.3389/fneur.2023.1209205 | DOI Listing |
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