Advances in Cerebellar TMS Therapy: An Updated Systematic Review on Multi-Session Interventions

<b>Introduction:</b> Cerebellar transcranial magnetic stimulation (TMS) has emerged as a promising neuromodulatory intervention for addressing motor, cognitive, and socio-affective deficits across a range of clinical populations. <b>Materials and Methods:</b> This systematic...

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Main Authors: Andrea Ciricugno, Sonia Paternò, Nicole Barbati, Renato Borgatti, Zaira Cattaneo, Chiara Ferrari
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/7/1578
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author Andrea Ciricugno
Sonia Paternò
Nicole Barbati
Renato Borgatti
Zaira Cattaneo
Chiara Ferrari
author_facet Andrea Ciricugno
Sonia Paternò
Nicole Barbati
Renato Borgatti
Zaira Cattaneo
Chiara Ferrari
author_sort Andrea Ciricugno
collection DOAJ
description <b>Introduction:</b> Cerebellar transcranial magnetic stimulation (TMS) has emerged as a promising neuromodulatory intervention for addressing motor, cognitive, and socio-affective deficits across a range of clinical populations. <b>Materials and Methods:</b> This systematic review aimed to synthesize recent evidence (2015–2025) on the efficacy, safety, and methodological characteristics of multi-session cerebellar TMS protocols used in rehabilitation settings. Following PRISMA guidelines, a comprehensive search of PubMed and Scopus was conducted to identify peer-reviewed studies applying multi-session cerebellar TMS in clinical populations for motor, cognitive, or affective rehabilitation. A total of 1750 records were screened, and 46 studies met the inclusion criteria. Data extraction included sample characteristics, study design, TMS protocol, targeted symptoms, outcomes, and risk of bias. <b>Results:</b> The results show that repeated sessions of cerebellar TMS are safe, well-tolerated, and associated with functional improvements primarily in motor disorders—such as spinocerebellar ataxia, Parkinson’s disease, multiple system atrophy, essential tremor, and post-stroke deficits—as well as in psychiatric populations, particularly patients with schizophrenia. <b>Discussion:</b> Evidence regarding the effects of cerebellar TMS on cognitive functions remains limited, though promising. Despite overall positive findings, the literature is limited by variability in stimulation parameters, protocol designs, and outcome measures, small sample sizes and potential publication bias. <b>Conclusions:</b> The review highlights the need for further large-scale and well-controlled trials to refine stimulation protocols, explore long-term effects, and clarify the underlying mechanisms of cerebellar TMS across motor, cognitive, and affective domains. This systematic review has been registered on PROSPERO (registration number: CRD420251067308).
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spelling doaj-art-f9b903dde7244debab22ccb7bd6300c22025-08-20T03:02:48ZengMDPI AGBiomedicines2227-90592025-06-01137157810.3390/biomedicines13071578Advances in Cerebellar TMS Therapy: An Updated Systematic Review on Multi-Session InterventionsAndrea Ciricugno0Sonia Paternò1Nicole Barbati2Renato Borgatti3Zaira Cattaneo4Chiara Ferrari5IRCCS Mondino Foundation, 27100 Pavia, ItalyDepartment of Brain and Behavioral Science, University of Pavia, 27100 Pavia, ItalyDepartment of Human and Social Sciences, University of Bergamo, 24129 Bergamo, ItalyIRCCS Mondino Foundation, 27100 Pavia, ItalyDepartment of Human and Social Sciences, University of Bergamo, 24129 Bergamo, ItalyIRCCS Mondino Foundation, 27100 Pavia, Italy<b>Introduction:</b> Cerebellar transcranial magnetic stimulation (TMS) has emerged as a promising neuromodulatory intervention for addressing motor, cognitive, and socio-affective deficits across a range of clinical populations. <b>Materials and Methods:</b> This systematic review aimed to synthesize recent evidence (2015–2025) on the efficacy, safety, and methodological characteristics of multi-session cerebellar TMS protocols used in rehabilitation settings. Following PRISMA guidelines, a comprehensive search of PubMed and Scopus was conducted to identify peer-reviewed studies applying multi-session cerebellar TMS in clinical populations for motor, cognitive, or affective rehabilitation. A total of 1750 records were screened, and 46 studies met the inclusion criteria. Data extraction included sample characteristics, study design, TMS protocol, targeted symptoms, outcomes, and risk of bias. <b>Results:</b> The results show that repeated sessions of cerebellar TMS are safe, well-tolerated, and associated with functional improvements primarily in motor disorders—such as spinocerebellar ataxia, Parkinson’s disease, multiple system atrophy, essential tremor, and post-stroke deficits—as well as in psychiatric populations, particularly patients with schizophrenia. <b>Discussion:</b> Evidence regarding the effects of cerebellar TMS on cognitive functions remains limited, though promising. Despite overall positive findings, the literature is limited by variability in stimulation parameters, protocol designs, and outcome measures, small sample sizes and potential publication bias. <b>Conclusions:</b> The review highlights the need for further large-scale and well-controlled trials to refine stimulation protocols, explore long-term effects, and clarify the underlying mechanisms of cerebellar TMS across motor, cognitive, and affective domains. This systematic review has been registered on PROSPERO (registration number: CRD420251067308).https://www.mdpi.com/2227-9059/13/7/1578cerebellumtranscranial magnetic stimulationrehabilitationmovement disorderspsychiatric disorders
spellingShingle Andrea Ciricugno
Sonia Paternò
Nicole Barbati
Renato Borgatti
Zaira Cattaneo
Chiara Ferrari
Advances in Cerebellar TMS Therapy: An Updated Systematic Review on Multi-Session Interventions
Biomedicines
cerebellum
transcranial magnetic stimulation
rehabilitation
movement disorders
psychiatric disorders
title Advances in Cerebellar TMS Therapy: An Updated Systematic Review on Multi-Session Interventions
title_full Advances in Cerebellar TMS Therapy: An Updated Systematic Review on Multi-Session Interventions
title_fullStr Advances in Cerebellar TMS Therapy: An Updated Systematic Review on Multi-Session Interventions
title_full_unstemmed Advances in Cerebellar TMS Therapy: An Updated Systematic Review on Multi-Session Interventions
title_short Advances in Cerebellar TMS Therapy: An Updated Systematic Review on Multi-Session Interventions
title_sort advances in cerebellar tms therapy an updated systematic review on multi session interventions
topic cerebellum
transcranial magnetic stimulation
rehabilitation
movement disorders
psychiatric disorders
url https://www.mdpi.com/2227-9059/13/7/1578
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