Effectiveness of Repetitive Transcranial Magnetic Stimulation in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review and Meta-analysis

Background: Dementia encompasses cognitive decline that significantly affects daily living. In recent years, there has been a notable shift toward nonpharmacological treatments, with transcranial magnetic stimulation (TMS) gaining attraction for its potential to enhance cognitive function in predeme...

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Main Authors: Palash Kumar Malo, Aishwarya Ghosh, Anjana J. Menon, G. Sandhya, Dwaiti Roy, Thomas Gregor Issac
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Journal of Psychiatry Spectrum
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Online Access:https://journals.lww.com/10.4103/jopsys.jopsys_31_24
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author Palash Kumar Malo
Aishwarya Ghosh
Anjana J. Menon
G. Sandhya
Dwaiti Roy
Thomas Gregor Issac
author_facet Palash Kumar Malo
Aishwarya Ghosh
Anjana J. Menon
G. Sandhya
Dwaiti Roy
Thomas Gregor Issac
author_sort Palash Kumar Malo
collection DOAJ
description Background: Dementia encompasses cognitive decline that significantly affects daily living. In recent years, there has been a notable shift toward nonpharmacological treatments, with transcranial magnetic stimulation (TMS) gaining attraction for its potential to enhance cognitive function in predementia and early Alzheimer’s Disease (AD). In this meta-analysis, we have integrated the results from different studies with varied protocols to explore the efficacy of repetitive TMS (rTMS) in improving cognitive functioning in people with mild cognitive impairment (MCI) and early AD. Methods: We used three databases, namely PubMed, MEDLINE, and PsycINFO. Studies until March 2024 were included. Mini–Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) were used to assess global cognition. A random-effects meta-analytical model was adopted, and Hedge’s g standardized mean differences (SMDs) and its 95% confidence intervals (CIs) were reported. The study protocol has been registered with PROSPERO (CRD42024507575). Results: Twenty-three studies were included in the meta-analysis. The mean (standard deviation) age of participants in studies using ADAS-Cog (71.8 [6.19] years) was found to be more than studies using MMSE (70.0 [6.72] years). Post-intervention MMSE scores were significantly better in active rTMS as compared to that of sham TMS (SMD [95% CI] =0.60 [0.15–1.04]; P = 0.009). However, the difference between the two study groups was not statistically significant for ADAS-Cog (−0.09 [−0.49 to 0.32]; [P = 0.67]). Sensitivity analyses for studies using MMSE also indicated that rTMS contributed to cognitive enhancement. Conclusions: The study found that active rTMS led to significant improvement in MMSE scores in people with MCI and early AD.
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spelling doaj-art-439247cb64cf48fbb30b4c971f8389822025-08-20T01:56:14ZengWolters Kluwer Medknow PublicationsJournal of Psychiatry Spectrum2949-69692025-01-0141919910.4103/jopsys.jopsys_31_24Effectiveness of Repetitive Transcranial Magnetic Stimulation in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review and Meta-analysisPalash Kumar MaloAishwarya GhoshAnjana J. MenonG. SandhyaDwaiti RoyThomas Gregor IssacBackground: Dementia encompasses cognitive decline that significantly affects daily living. In recent years, there has been a notable shift toward nonpharmacological treatments, with transcranial magnetic stimulation (TMS) gaining attraction for its potential to enhance cognitive function in predementia and early Alzheimer’s Disease (AD). In this meta-analysis, we have integrated the results from different studies with varied protocols to explore the efficacy of repetitive TMS (rTMS) in improving cognitive functioning in people with mild cognitive impairment (MCI) and early AD. Methods: We used three databases, namely PubMed, MEDLINE, and PsycINFO. Studies until March 2024 were included. Mini–Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) were used to assess global cognition. A random-effects meta-analytical model was adopted, and Hedge’s g standardized mean differences (SMDs) and its 95% confidence intervals (CIs) were reported. The study protocol has been registered with PROSPERO (CRD42024507575). Results: Twenty-three studies were included in the meta-analysis. The mean (standard deviation) age of participants in studies using ADAS-Cog (71.8 [6.19] years) was found to be more than studies using MMSE (70.0 [6.72] years). Post-intervention MMSE scores were significantly better in active rTMS as compared to that of sham TMS (SMD [95% CI] =0.60 [0.15–1.04]; P = 0.009). However, the difference between the two study groups was not statistically significant for ADAS-Cog (−0.09 [−0.49 to 0.32]; [P = 0.67]). Sensitivity analyses for studies using MMSE also indicated that rTMS contributed to cognitive enhancement. Conclusions: The study found that active rTMS led to significant improvement in MMSE scores in people with MCI and early AD.https://journals.lww.com/10.4103/jopsys.jopsys_31_24alzheimer’s disease assessment scale-cognitive subscalealzheimer’s diseasecognitionmild cognitive impairmentmini–mental state examinationtranscranial magnetic stimulation
spellingShingle Palash Kumar Malo
Aishwarya Ghosh
Anjana J. Menon
G. Sandhya
Dwaiti Roy
Thomas Gregor Issac
Effectiveness of Repetitive Transcranial Magnetic Stimulation in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review and Meta-analysis
Journal of Psychiatry Spectrum
alzheimer’s disease assessment scale-cognitive subscale
alzheimer’s disease
cognition
mild cognitive impairment
mini–mental state examination
transcranial magnetic stimulation
title Effectiveness of Repetitive Transcranial Magnetic Stimulation in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review and Meta-analysis
title_full Effectiveness of Repetitive Transcranial Magnetic Stimulation in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review and Meta-analysis
title_fullStr Effectiveness of Repetitive Transcranial Magnetic Stimulation in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review and Meta-analysis
title_full_unstemmed Effectiveness of Repetitive Transcranial Magnetic Stimulation in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review and Meta-analysis
title_short Effectiveness of Repetitive Transcranial Magnetic Stimulation in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review and Meta-analysis
title_sort effectiveness of repetitive transcranial magnetic stimulation in mild cognitive impairment and early alzheimer s disease a systematic review and meta analysis
topic alzheimer’s disease assessment scale-cognitive subscale
alzheimer’s disease
cognition
mild cognitive impairment
mini–mental state examination
transcranial magnetic stimulation
url https://journals.lww.com/10.4103/jopsys.jopsys_31_24
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