Efficacy of non-invasive brain stimulation interventions on cognitive impairment: an umbrella review of meta-analyses of randomized controlled trials
Abstract Background The impact of noninvasive brain stimulation (NIBS) on cognitive and mental outcomes in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) remains under debate due to contradictory findings from systematic reviews and meta-analyses (SRMAs). To synthesize evidence from SR...
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BMC
2025-02-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
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| Online Access: | https://doi.org/10.1186/s12984-025-01566-3 |
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| author | Minmin Wu Wenjing Song Xue Wang Lili Teng Jinting Li Jiongliang Zhang Xinyue Li Donghui Yu Huanhuan Jia Binhan Wang Qiang Tang Luwen Zhu |
| author_facet | Minmin Wu Wenjing Song Xue Wang Lili Teng Jinting Li Jiongliang Zhang Xinyue Li Donghui Yu Huanhuan Jia Binhan Wang Qiang Tang Luwen Zhu |
| author_sort | Minmin Wu |
| collection | DOAJ |
| description | Abstract Background The impact of noninvasive brain stimulation (NIBS) on cognitive and mental outcomes in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) remains under debate due to contradictory findings from systematic reviews and meta-analyses (SRMAs). To synthesize evidence from SRMAs assessing the effectiveness of NIBS techniques on cognitive and mental outcomes in AD and MCI populations. By comparing our findings to recent reviews and clinical guidelines, we highlight how this study addresses current limitations in the literature, provides a more holistic perspective on NIBS interventions, and guides future research and clinical practice. Methods We searched four databases from inception to May 15, 2024, reviewing SRMAs that analyzed the effects of NIBS. Effect sizes, 95% confidence intervals (CIs), and prediction intervals were computed for each meta-analysis. The methodological quality of the SRMAs was evaluated using the Measurement Tool to Assess Systematic Reviews 2, and the quality of evidence was assessed through the Grading of Recommendations, Assessment, Development, and Evaluation criteria. Findings Ten SRMAs detailing 22 associations were analyzed, focusing on two NIBS techniques across 12 unique outcomes. Significant improvements were observed in global cognition, language, executive function, and memory. Repetitive transcranial magnetic stimulation (rTMS) significantly enhanced short-term global cognition (standardized mean difference [SMD], 0.44; 95% CI 0.02–0.86), language (SMD, 1.64; 95% CI 1.22–2.06), executive function (SMD, 1.64; 95% CI 0.18–0.83), and long-term global cognition (SMD, 0.29; 95% CI 0.07–0.50). Transcranial direct current stimulation (tDCS) was effective in improving memory (SMD, 0.60; 95% CI 0.32–0.89) and executive function (SMD, 0.39; 95% CI 0.08–0.71). NIBS interventions showed no significant correlation with neuropsychiatric symptoms but demonstrated good tolerability in terms of safety and acceptability. Interpretation This umbrella review indicates that NIBS techniques, particularly rTMS and tDCS, can significantly improve cognitive functions such as global cognition, language, executive functions, and memory in patients with AD and MCI. Despite potential benefits, results should be interpreted cautiously due to study heterogeneity and methodological limitations. Future studies should investigate their long-term effects and applicability across dementia types. Graphical Abstract |
| format | Article |
| id | doaj-art-90eace540c5b42408437cba3cee78402 |
| institution | Kabale University |
| issn | 1743-0003 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj-art-90eace540c5b42408437cba3cee784022025-02-09T12:16:08ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032025-02-0122111410.1186/s12984-025-01566-3Efficacy of non-invasive brain stimulation interventions on cognitive impairment: an umbrella review of meta-analyses of randomized controlled trialsMinmin Wu0Wenjing Song1Xue Wang2Lili Teng3Jinting Li4Jiongliang Zhang5Xinyue Li6Donghui Yu7Huanhuan Jia8Binhan Wang9Qiang Tang10Luwen Zhu11Department of Rehabilitation Medicine, Heilongjiang University of Chinese MedicineDepartment of Rehabilitation Medicine, Heilongjiang University of Chinese MedicineRehabilitation Center, The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineDepartment of Rehabilitation Medicine, Heilongjiang University of Chinese MedicineDepartment of Rehabilitation Medicine, Heilongjiang University of Chinese MedicineDepartment of Rehabilitation Medicine, Heilongjiang University of Chinese MedicineDepartment of Rehabilitation Medicine, Heilongjiang University of Chinese MedicineDepartment of Rehabilitation Medicine, Heilongjiang University of Chinese MedicineDepartment of Rehabilitation Medicine, Heilongjiang University of Chinese MedicineDepartment of Rehabilitation Medicine, Heilongjiang University of Chinese MedicineRehabilitation Center, The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineRehabilitation Center, The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineAbstract Background The impact of noninvasive brain stimulation (NIBS) on cognitive and mental outcomes in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) remains under debate due to contradictory findings from systematic reviews and meta-analyses (SRMAs). To synthesize evidence from SRMAs assessing the effectiveness of NIBS techniques on cognitive and mental outcomes in AD and MCI populations. By comparing our findings to recent reviews and clinical guidelines, we highlight how this study addresses current limitations in the literature, provides a more holistic perspective on NIBS interventions, and guides future research and clinical practice. Methods We searched four databases from inception to May 15, 2024, reviewing SRMAs that analyzed the effects of NIBS. Effect sizes, 95% confidence intervals (CIs), and prediction intervals were computed for each meta-analysis. The methodological quality of the SRMAs was evaluated using the Measurement Tool to Assess Systematic Reviews 2, and the quality of evidence was assessed through the Grading of Recommendations, Assessment, Development, and Evaluation criteria. Findings Ten SRMAs detailing 22 associations were analyzed, focusing on two NIBS techniques across 12 unique outcomes. Significant improvements were observed in global cognition, language, executive function, and memory. Repetitive transcranial magnetic stimulation (rTMS) significantly enhanced short-term global cognition (standardized mean difference [SMD], 0.44; 95% CI 0.02–0.86), language (SMD, 1.64; 95% CI 1.22–2.06), executive function (SMD, 1.64; 95% CI 0.18–0.83), and long-term global cognition (SMD, 0.29; 95% CI 0.07–0.50). Transcranial direct current stimulation (tDCS) was effective in improving memory (SMD, 0.60; 95% CI 0.32–0.89) and executive function (SMD, 0.39; 95% CI 0.08–0.71). NIBS interventions showed no significant correlation with neuropsychiatric symptoms but demonstrated good tolerability in terms of safety and acceptability. Interpretation This umbrella review indicates that NIBS techniques, particularly rTMS and tDCS, can significantly improve cognitive functions such as global cognition, language, executive functions, and memory in patients with AD and MCI. Despite potential benefits, results should be interpreted cautiously due to study heterogeneity and methodological limitations. Future studies should investigate their long-term effects and applicability across dementia types. Graphical Abstracthttps://doi.org/10.1186/s12984-025-01566-3Non-invasive brain stimulationMild cognitive impairmentAlzheimer’s diseaseGRADEUmbrella review |
| spellingShingle | Minmin Wu Wenjing Song Xue Wang Lili Teng Jinting Li Jiongliang Zhang Xinyue Li Donghui Yu Huanhuan Jia Binhan Wang Qiang Tang Luwen Zhu Efficacy of non-invasive brain stimulation interventions on cognitive impairment: an umbrella review of meta-analyses of randomized controlled trials Journal of NeuroEngineering and Rehabilitation Non-invasive brain stimulation Mild cognitive impairment Alzheimer’s disease GRADE Umbrella review |
| title | Efficacy of non-invasive brain stimulation interventions on cognitive impairment: an umbrella review of meta-analyses of randomized controlled trials |
| title_full | Efficacy of non-invasive brain stimulation interventions on cognitive impairment: an umbrella review of meta-analyses of randomized controlled trials |
| title_fullStr | Efficacy of non-invasive brain stimulation interventions on cognitive impairment: an umbrella review of meta-analyses of randomized controlled trials |
| title_full_unstemmed | Efficacy of non-invasive brain stimulation interventions on cognitive impairment: an umbrella review of meta-analyses of randomized controlled trials |
| title_short | Efficacy of non-invasive brain stimulation interventions on cognitive impairment: an umbrella review of meta-analyses of randomized controlled trials |
| title_sort | efficacy of non invasive brain stimulation interventions on cognitive impairment an umbrella review of meta analyses of randomized controlled trials |
| topic | Non-invasive brain stimulation Mild cognitive impairment Alzheimer’s disease GRADE Umbrella review |
| url | https://doi.org/10.1186/s12984-025-01566-3 |
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