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

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 optimal TMS parameters has not reached consensus. The purpose meta-analysis was to systematically discern different components protocols on improvement patients mild impairment (MCI) AD. Methods preregistered Prospero (registration number: CRD42022345482). PubMed, Web Science, Science Direct, Cochrane Library databases were used search, screen identify eligible studies following keywords: Magnetic Stimulation OR theta burst AND Alzheimer Alzheimers MCI. Randomized controlled trials (RCTs) participants accepted standardized diagnostic criteria searched by two authors independently. risk bias assessed using an adapted Risk Bias tool. Standardized mean difference (SMD) 95% confidence interval (CI) calculated random-effects models. Subgroup analyses performed investigate influential factors. Results A total 21 25 included meta-analysis. findings revealed significant overall cognition real compared sham (short-term effects: SMD, 0.91; CI 0.44–1.38; P < 0.01; long-lasting 0.27–1.55; 0.01). analysis demonstrated left dorsolateral prefrontal cortex bilateral cerebellums, as well moderate frequency (5 Hz 10 Hz) patients, more effective than other protocols. additional application training showed no improvement. Conclusion Cognitive effect MCI AD both short-term assessment outcomes, efficiency affected frequency, site, participant characteristics. Further RCTs are needed validate our subgroup analysis. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022345482 , identifier: CRD42022345482.