Cheng, P., Wong, S., Lee, K., Chan, P., Yeung, W. and Chan, W. (2017). Effects of repetitive transcranial magnetic stimulation on improvement of cognition in elderly patients with cognitive impairment: A systematic review and meta-analysis. Brain Stimulation, 10(2), 506-507.
At the date of publication, this was the largest systematic review and meta-analysis of the use of rTMS in geriatric cognitive decline, such as Alzheimer’s disease (AD). The final analysis examined cognitive functioning across 107 participants in active rTMS and 87 sham participants. The studies included rTMS alone, or in combination with cognitive training or medications. Most studies targeted the dorsolateral prefrontal cortex (DLPFC) either unilaterally or bilaterally, but combinations of target sites were also included involving; Broca’s area, Wernicke’s area, and the parietal cortex. Most studies used high frequency rTMS (10-20Hz) compared to a minority using low frequency (1Hz). Stimulus intensity ranged from 80-120% of motor threshold, typically delivering 1200-2250 pulses per session, and usually for at least five sessions (1-30 sessions range). rTMS was shown to have a moderate effect size for improving cognitive functioning, with the strongest evidence being for high frequency stimulation in studies that investigated rTMS alone versus sham, as opposed to those with combined cognitive training or medications. This was possibly due to smaller sample sizes in the latter studies. Whilst the authors noted there is some evidence suggesting high frequency stimulation over the right or bilateral DLPFC may be more effective, they concluded that more research is needed regarding the most effective stimulation sites in geriatric cognitive decline.
*For original abstract/publication see the link below.
Publication link: Effects of repetitive transcranial magnetic stimulation on improvement of cognition in elderly patients with cognitive impairment: a systematic review and meta‐analysis – Cheng – 2018 – International Journal of Geriatric Psychiatry – Wiley Online Library