Zhenyu Wei1, Jiaqi Fu2, Huazheng Liang3,4, Mingli Liu1, Xiaofei Ye5, Ping Zhong1,2. 1. Department of Neurology, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, Shanghai, China. 2. School of Health Science and Engineering, Shanghai University of Science and Technology, Shanghai, China. 3. Clinical Research Center for Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China. 4. Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China. 5. Department of Statistics, Naval Medical University, Shanghai, China.
Abstract
Background: Repetitive Transcranial Magnetic Stimulation (rTMS) is widely used to treat Alzheimer's Disease. However, the effect of rTMS is still controversial. The purpose of the present study is to evaluate the effectiveness of rTMS on cognitive performance of AD patients. Methods: We systematically searched relevant literatures in four major databases - PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials [Central] before 28 th April 2022. Both randomized controlled trials and cross-section studies that compared the therapeutic effect of rTMS with blank control or sham stimuli were included. Results: A total of 14 studies involving 513 AD patients were finally included for meta-analysis. It was found that rTMS significantly improved global cognitive function (SMD = 0.24, 95%CI, 0.12 to 0.36, P = 0.0001) and daily living ability (IADL: SMD = 0.64, 95%CI, 0.21to 1.08, P = 0.004) in patients with AD, but did not show improvement in language, memory, executive ability, and mood. In further analyses, rTMS at 10 Hz, on a single target with 20 sessions of treatment was shown to produce a positive effect. In addition, improvement in cognitive functions lasted for at least 6 weeks (SMD = 0.67, 95%CI, 0.05 to 1.30,P = 0.04). Conclusion: rTMS can improve the global cognition and daily living ability of AD patients. In addition, attention should be paid to the safety of rTMS in AD patients with seizures. Given the relatively small sample size, our results should be interpreted with caution.
Background: Repetitive Transcranial Magnetic Stimulation (rTMS) is widely used to treat Alzheimer's Disease. However, the effect of rTMS is still controversial. The purpose of the present study is to evaluate the effectiveness of rTMS on cognitive performance of AD patients. Methods: We systematically searched relevant literatures in four major databases - PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials [Central] before 28 th April 2022. Both randomized controlled trials and cross-section studies that compared the therapeutic effect of rTMS with blank control or sham stimuli were included. Results: A total of 14 studies involving 513 AD patients were finally included for meta-analysis. It was found that rTMS significantly improved global cognitive function (SMD = 0.24, 95%CI, 0.12 to 0.36, P = 0.0001) and daily living ability (IADL: SMD = 0.64, 95%CI, 0.21to 1.08, P = 0.004) in patients with AD, but did not show improvement in language, memory, executive ability, and mood. In further analyses, rTMS at 10 Hz, on a single target with 20 sessions of treatment was shown to produce a positive effect. In addition, improvement in cognitive functions lasted for at least 6 weeks (SMD = 0.67, 95%CI, 0.05 to 1.30,P = 0.04). Conclusion: rTMS can improve the global cognition and daily living ability of AD patients. In addition, attention should be paid to the safety of rTMS in AD patients with seizures. Given the relatively small sample size, our results should be interpreted with caution.
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