Effects of Repetitive Transcranial Magnetic Stimulation on Improvement of Cognition in Elderly Patients with Cognitive Impairment

TITLE
Effects of Repetitive Transcranial Magnetic Stimulation on Improvement of Cognition in Elderly Patients with Cognitive Impairment: a Systematic Review and Meta-Analysis [Review]

AUTHORS
Cheng CPW; Wong CSM; Lee KK; Chan APK; Yeung JWF; Chan WC.

SOURCE
International Journal of Geriatric Psychiatry. 33(1):e1-e13, 2018 Jan.

OBJECTIVE
This systematic review and meta-analysis aimed to examine the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive function in older patients with cognitive impairment.

METHODS
A literature search was performed for articles published in English using the 10 databases (MEDLINE, EMBASE, PsycINFO, INSPEC, the Cumulative Index to Nursing and Allied Health Literature Plus, AMED, Biological Sciences, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews) from their inception to May 2016. The primary outcome was cognitive function as measured by the Mini-Mental State Examination or the Alzheimer’s Disease Assessment Scale-cognitive subscale.

RESULTS
Seven RCTs were included in the meta-analysis, with a sample of 107 active and 87 sham rTMS. Active rTMS was found to be more effective in improving cognition (Hedges’ g = 0.48; 95% confidence interval 0.12 to 0.84).

CONCLUSIONS
High-frequency rTMS showed a benefit on cognition amongst older patients with mild to moderate Alzheimer’s disease. rTMS was shown to have great potential as a safe and well-tolerated alternative intervention for cognition.