Pubblicazioni

Transcranial magnetic stimulation effects on cognitive enhancement in mild cognitive impairment and Alzheimer's disease: a systematic review and meta-analysis

Yan, Y.; Tian, M.; Wang, T.; Wang, X.; Wang, Y.; Shi, J.

Abstract:

Introduction Transcranial magnetic stimulation (TMS) is a non-invasive intervention that holds promise for improving cognitive function in individuals with Alzheimer's disease (AD). However, the effectiveness of this therapy and the optimal TMS parameters has not reached a consensus. The purpose of the meta-analysis was to systematically discern the effectiveness of different components of TMS protocols on cognitive improvement in patients with mild cognitive impairment (MCI) and AD. Methods The meta-analysis was preregistered on Prospero (registration number: CRD42022345482). PubMed, Web of Science, Science Direct, and Cochrane Library databases were used to search, screen and identify eligible studies with the following keywords: Transcranial Magnetic Stimulation OR TMS OR theta burst stimulation AND Alzheimer OR Alzheimers OR Alzheimer's OR mild cognitive impairment OR MCI. Randomized controlled trials (RCTs) of participants with accepted standardized diagnostic criteria were searched by two authors independently. The risk of bias was assessed using an adapted Cochrane Risk of Bias tool. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated using the random-effects models. Subgroup analyses were performed to investigate the influential factors. Results A total of 21 studies and 25 trials were included in this meta-analysis. The findings revealed a significant overall cognition improvement of real stimulation compared with sham stimulation (short-term effects: SMD, 0.91; 95% CI 0.44-1.38; P < 0.01; long-lasting effects: SMD, 0.91; 95% CI 0.27-1.55; P < 0.01). Subgroup analysis demonstrated that stimulation of the left dorsolateral prefrontal cortex and bilateral cerebellums, as well as moderate frequency stimulation (5 Hz and 10 Hz) on mild and moderate cognitive impairment patients, were more effective than other TMS protocols. However, the additional application of cognitive training showed no significant improvement. Conclusion Cognitive improvement effect of TMS was demonstrated in MCI and AD patients in both short-term assessment and long-lasting outcomes, and the efficiency of TMS is affected by the stimulation frequency, stimulation site, and participant characteristics. Further RCTs are needed to validate the findings of our subgroup analysis.

Patologie/Applicazioni:

• Riabilitazione cognitiva
• Stimolazione Magnetica Transcranica (TMS)
• Riabilitazione motoria
• Alzheimer

Anno:

2023

Tipo di pubblicazione:

Articolo

Parola chiave:

neuroplasticità; NIBS; riabilitazione cognitiva; Riabilitazione motoria; TMS; stimolazione magnetica transcranica; Alzheimer; decadimento cognitivo lieve; AD; MCI

Testata scientifica:

Frontiers

Mese:

07

Nota:

Lo scopo di questa meta-analisi era quello di discernere sistematicamente l'efficacia dei diversi componenti dei protocolli TMS sul miglioramento cognitivo nei pazienti con decadimento cognitivo lieve (MCI) e AD. Le analisi hanno dimostrato un effetto di miglioramento cognitivo della TMS nei pazienti con MCI e AD sia nella valutazione a breve termine che nei risultati a lungo termine, e che la stimolqazsione magnetica transcranica (TMS) è influenzata dalla frequenza di stimolazione, dal sito di stimolazione e dalle caratteristiche dei partecipanti.

DOI:

10.3389/fneur.2023.1209205