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PLoS One. 2018 Oct 12;13(10):e0205704. doi: 10.1371/journal.pone.0205704. eCollection 2018.

Repetitive transcranial magnetic stimulation for the treatment of Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials.

Author information

1
Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
2
Department of Special Medicine, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu Province, China.
3
Department of Clinical Medicine, Xuzhou Medical University, Xuzhou, Jiangsu Province, China.

Abstract

BACKGROUND:

Several studies have demonstrated that repetitive transcranial magnetic stimulation (rTMS) may have a beneficial effect in Alzheimer's disease (AD). Nevertheless, the clinical benefit of rTMS for AD remains inconclusive.

OBJECTIVE:

This systematic review and meta-analysis aimed to evaluate the efficacy and safety of rTMS in AD.

METHODS:

We searched PubMed, Embase and Cochrane for randomized controlled trials (RCTs) of rTMS for AD. We calculated pooled estimates of mean difference (MD) with 95% confidence intervals (CI). The protocol was registered at International Prospective Register of Systematic Reviews (PROSPERO) (number CRD42018089990).

RESULTS:

Five RCTs involving 148 participants were included in this review. Compared with sham stimulation, high-frequency rTMS led to a significant improvement in cognition as measured by ADAS-cog (MD = -3.65, 95% CI -5.82 to -1.48, p = 0.001), but not MMSE (MD = 0.49, 95% CI -1.45 to 2.42, p = 0.62). High-frequency rTMS also improved the global impression in comparison to the placebo (MD = -0.79, 95% CI -1.24 to -0.34, p = 0.0006). There was no significant difference in mood (MD = -1.36, 95% CI -3.93 to 1.21, p = 0.30) and functional performance (MD = 0.59, 95% CI -1.21 to 2.38, p = 0.52) between high-frequency rTMS and sham groups. Only one trial included low-frequency rTMS reported no significant improvement in cognition, mood and functional performance. Few mild adverse events were observed in both the rTMS and sham groups.

CONCLUSIONS:

RTMS is relatively well tolerated, with some promise for cognitive improvement and global impression in patients with AD. Our findings also indicate the variability between ADAS-cog and MMSE in evaluating global cognitive impairment.

PMID:
30312319
PMCID:
PMC6185837
DOI:
10.1371/journal.pone.0205704
[Indexed for MEDLINE]
Free PMC Article

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