Cognitive enhancing effects of rTMS administered to the prefrontal cortex in patients with depression: A systematic review and meta-analysis of individual task effects
Abstract
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is an approved therapeutic treatment of major depressive disorder and has increasing clinical use throughout the world. However, it remains unclear whether an rTMS course for depression may also produce cognitive enhancement. In a recent meta-analysis of sham-controlled randomized controlled studies (RCTs) conducted in patients with neuropsychiatric conditions, no evidence was found for generalized cognitive enhancing effects across cognitive domains with active compared to sham rTMS. Notwithstanding, there remains the possibility of cognitive effects following an rTMS course that are more highly specific, for example, in specific clinical conditions, or at the individual task level. This study aimed to determine whether a therapeutic rTMS course in patients with depression is associated with cognitive enhancing effects at the task level. METHODS: A systematic review and meta-analysis of outcomes on individual neuropsychological tasks from sham-controlled RCTs where an rTMS course was administered to the dorsolateral prefrontal cortex (DLPFC) in patients with depression. RESULTS: Eighteen studies met the inclusion criteria. Active rTMS treatment showed no specific enhancing effects on the majority of cognitive tasks. Modest effect size improvements with active compared to sham rTMS treatment were found for performance on the Trail Making Test Parts A (g = 0.28, 95% CI = 0.06-0.50) and B (g = 0.26, 95% CI = 0.06-0…
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Findings on cognitive effects of rTMS have been inconsistent, and large meta-analyses have not demonstrated robust cognitive effects, with only modest effects observed in specific cognitive tasks.
“However, findings have been inconsistent and large meta-analyses have not demonstrated robust cognitive effects, 27 with only modest effects observed in specific cognitive tasks.”
rTMS is considered cognitively safe with mixed evidence regarding its potential for cognitive enhancing properties.
“Importantly, rTMS is considered cognitively safe with mixed evidence regarding its potential for cognitive enhancing properties (Gregory et al., 2022;Kavanaugh et al., 2018;Martin et al., 2017;Schulze-Rauschenbach et al., 2005;Serafini et al., 2015;Wall et al., 2013;Yildiz et al., 2023).”
From Neurocognitive effects of theta burst stimulation for treatment-resistant depression in adults: A systematic review and recommendations for future research (2025) · cites this paper as Martin et al., 2017
Evidence has suggested that TMS may improve psychomotor speed, visual scanning, and set-shifting ability among individuals with TRD.
“For example, evidence has suggested that TMS may improve psychomotor speed, visual scanning, and set-shifting ability among individuals with TRD (Martin et al., 2017).”
From Neurocognitive effects of theta burst stimulation for treatment-resistant depression in adults: A systematic review and recommendations for future research (2025) · cites this paper as Martin et al., 2017
Previous reviews have suggested that standard rTMS for TRD may produce modest cognitive enhancing effects.
“Of note, previous reviews (Martin et al., 2017;Serafini et al., 2015) have suggested that standard rTMS for TRD may produce modest cognitive enhancing effects”
From Neurocognitive effects of theta burst stimulation for treatment-resistant depression in adults: A systematic review and recommendations for future research (2025) · cites this paper as Martin et al., 2017
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Self-citation
- Authors
- Martin, D. M., McClintock, S. M., Forster, J. J., Lo, T. Y., & Loo, C. K.
- Affiliations
- Black Dog Institute (AU)
- Duke University (US)
- Corresponding author
- Martin, Donel M.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2017-05-24
- Volume
- 34
- Issue
- 11
- Pages
- 1029-1039
- ISSN
- 1091-4269 (ISSN-L)
- OpenAlex
- W2616986695
- Cited by
- 162
- References
- 9
- Citations by year
- 2026: 8 · 2025: 21 · 2024: 20 · 2023: 26 · 2022: 17 · 2021: 19 · 2020: 17 · 2019: 16 · 2018: 16 · 2017: 2
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Alliance for Research on Schizophrenia and Depression
- Miyuki Giken
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- repetitive transcranial magnetic stimulation, major depressive disorder, dorsolateral prefrontal cortex, cognitive enhancement, Trail Making Test, psychomotor speed, visual exploration, set-shifting
- MeSH terms
- Cognition, Depression, Major Depressive Disorder, Female, Humans, Male, Research Design, Randomized Controlled Trials as Topic, Treatment Outcome, Prefrontal Cortex, Transcranial Magnetic Stimulation
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