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Efficacy and safety of transcranial magnetic stimulation on cognition in mild cognitive impairment, Alzheimer’s disease, Alzheimer’s disease-related dementias, and other cognitive disorders: a systematic review and meta-analysis

认知 疾病 阿尔茨海默病 荟萃分析 心理信息 医学 随机对照试验 蒙特利尔认知评估 梅德林 系统回顾 小型精神状态检查 精神科 心理学 认知障碍 内科学 法学 政治学
作者
Sandeep R. Pagali,Rakesh Kumar,Allison LeMahieu,Michael R. Basso,Bradley F. Boeve,Paul E. Croarkin,Jennifer R. Geske,Leslie C. Hassett,John Huston,Simon Kung,Brian N. Lundstrom,Ronald C. Petersen,Erik K. St. Louis,Kirk M. Welker,Gregory A. Worrell,Álvaro Pascual‐Leone,Maria I. Lapid
出处
期刊:International Psychogeriatrics 卷期号:36 (10): 880-928 被引量:4
标识
DOI:10.1017/s1041610224000085
摘要

ABSTRACT Objective: We aim to analyze the efficacy and safety of TMS on cognition in mild cognitive impairment (MCI), Alzheimer’s disease (AD), AD-related dementias, and nondementia conditions with comorbid cognitive impairment. Design: Systematic review, Meta-Analysis Setting: We searched MEDLINE, Embase, Cochrane database, APA PsycINFO, Web of Science, and Scopus from January 1, 2000, to February 9, 2023. Participants and interventions: RCTs, open-label, and case series studies reporting cognitive outcomes following TMS intervention were included. Measurement: Cognitive and safety outcomes were measured. Cochrane Risk of Bias for RCTs and MINORS (Methodological Index for Non-Randomized Studies) criteria were used to evaluate study quality. This study was registered with PROSPERO (CRD42022326423). Results: The systematic review included 143 studies ( n = 5,800 participants) worldwide, encompassing 94 RCTs, 43 open-label prospective, 3 open-label retrospective, and 3 case series. The meta-analysis included 25 RCTs in MCI and AD. Collectively, these studies provide evidence of improved global and specific cognitive measures with TMS across diagnostic groups. Only 2 studies (among 143) reported 4 adverse events of seizures: 3 were deemed TMS unrelated and another resolved with coil repositioning. Meta-analysis showed large effect sizes on global cognition (Mini-Mental State Examination (SMD = 0.80 [0.26, 1.33], p = 0.003), Montreal Cognitive Assessment (SMD = 0.85 [0.26, 1.44], p = 0.005), Alzheimer’s Disease Assessment Scale–Cognitive Subscale (SMD = −0.96 [−1.32, −0.60], p < 0.001)) in MCI and AD, although with significant heterogeneity. Conclusion: The reviewed studies provide favorable evidence of improved cognition with TMS across all groups with cognitive impairment. TMS was safe and well tolerated with infrequent serious adverse events.
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