Does Therapeutic Repetitive Transcranial Magnetic Stimulation Cause Cognitive Enhancing Effects in Patients with Neuropsychiatric Conditions? A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Open accessAbstract
Repetitive transcranial magnetic stimulation (rTMS) is increasingly used as a therapeutic intervention for neuropsychiatric illnesses and has demonstrated efficacy for treatment of major depression. However, an unresolved question is whether a course of rTMS treatment results in effects on cognitive functioning. In this systematic review and meta-analysis we aimed to quantitatively determine whether a course of rTMS has cognitive enhancing effects. We examined cognitive outcomes from randomised, sham-controlled studies conducted in patients with neuropsychiatric conditions where rTMS was administered to the dorsolateral prefrontal cortex (DLPFC) across repeated sessions, searched from PubMed/MEDLINE and other databases up until October 2015. Thirty studies met our inclusion criteria. Cognitive outcomes were pooled and examined across the following domains: Global cognitive function, executive function, attention, working memory, processing speed, visual memory, verbal memory and visuospatial ability. Active rTMS treatment was unassociated with generalised gains across the majority of domains of cognitive functioning examined. Secondary analyses revealed a moderate sized positive effect for improved working memory in a small number of studies in patients with schizophrenia (k = 3, g = 0.507, 95 % CI = [0.183-0.831], p < .01). Therapeutic rTMS when administered to the DLPFC in patients with neuropsychiatric conditions does not result in robust cognitive enhancing effects.
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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.”
In their meta-analysis of randomized control trials, Martin et al. (2016) found that active rTMS did not have a robust effect on multiple cognitive domains across studies of multiple psychiatric disorders.
“Notably, in their meta-analysis of randomized control trials (RCTs), Martin et al. (2016) found that active rTMS did not have a robust effect on multiple cognitive domains across studies of multiple psychiatric disorders.”
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., 2016
Prior systematic reviews of DLPFC stimulation effects on cognition across psychiatric disorders found no improvement in attention domains and only found significant improvements in working memory and verbal memory.
“This finding is in accordance with prior systematic reviews of DLPFC stimulation effects on cognition across psychiatric disorders which found no improvement in attention domains (including selective, sustained, and divided) and only found significant improvements in working memory137 and verbal memory138.”
From Paying attention to attention in depression (2019) · cites this paper as [137]
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Ragland, J. D., Charan Ranganath, A., Phillips, J., Boudewyn, M. A., Kring, A. M., Lesh, T. A., Long, D. L., Luck, S. J., Niendam, T. A., Solomon, M., et al. (2015) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2015.00604 · Cited by 25 · see citing works
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Begemann, M. J., Brand, B. A., Ćurčić-Blake, B., Aleman, A., & Sommer, I. E. (2020) · Psychological Medicine · doi:10.1017/s0033291720003670 · Cited by 368 · see citing works
Paying attention to attention in depression
Keller, A. S., Leikauf, J. E., Holt-Gosselin, B., Staveland, B. R., & Williams, L. M. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0616-1 · Cited by 329 · see citing works
Iimori, T., Nakajima, S., Miyazaki, T., Tarumi, R., Ogyu, K., Wada, M., Tsugawa, S., Masuda, F., Daskalakis, Z. J., Blumberger, D. M., et al. (2019) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.06.014 · Cited by 94 · see citing works
Kavanaugh, B. C., Aaronson, S. T., Clarke, G. N., Holtzheimer, P. E., Johnson, C. W., McDonald, W. M., Schneider, M. B., & Carpenter, L. L. (2018) · The Journal of ECT · doi:10.1097/yct.0000000000000494 · Cited by 25 · see citing works
Meek, B. P., Hill, S., & Modirrousta, M. (2021) · Brain Injury · doi:10.1080/02699052.2020.1857837 · Cited by 16 · see citing works
Holczer, A., Németh, V. L., Vékony, T., Kocsis, K., Király, A., Kincses, Z. T., Vécsei, L., Klivényi, P., & Must, A. (2021) · Neuroscience · doi:10.1016/j.neuroscience.2021.03.001 · Cited by 15 · see citing works
Göke, K., McClintock, S. M., Mah, L., Rajji, T. K., Lee, H. H., Nestor, S. M., Downar, J., Noda, Y., Daskalakis, Z. J., Mulsant, B. H., et al. (2026) · The Canadian Journal of Psychiatry · doi:10.1177/07067437251315515 · Cited by 4 · see citing works
Self-citationHutnyan, M., & McClintock, S. M. (2025) · Transcranial Magnetic Stimulation · doi:10.1016/j.transm.2025.100088 · Cited by 2 · see citing works
Self-citation
- Authors
- Martin, D. M., McClintock, S. M., Forster, J., & Loo, C. K.
- Affiliations
- Black Dog Institute (AU)
- Duke University (US)
- UNSW Sydney (AU)
- Corresponding author
- Martin, Donel M.
- Venue
- Neuropsychology Review
- Published
- 2016-09
- Volume
- 26
- Issue
- 3
- Pages
- 295-309
- ISSN
- 1040-7308 (ISSN-L)
- 1573-6660
- PMC
- PMC5949868
- OpenAlex
- W2510023404
- Cited by
- 76
- References
- 85
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 10 · 2023: 9 · 2022: 7 · 2021: 6 · 2020: 10 · 2019: 6 · 2018: 4 · 2017: 6 · 2016: 1
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Neuropsychology Review (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23MH087739)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neuroethics, Human Enhancement, Biomedical Innovations
- Keywords
- repetitive transcranial magnetic stimulation, cognitive enhancement, neuropsychiatric disorders, dorsolateral prefrontal cortex, working memory, executive function, attention, processing speed, memory, schizophrenia, major depressive disorder
- MeSH terms
- Mental Disorders, Cognition, Humans, Randomized Controlled Trials as Topic, Transcranial Magnetic Stimulation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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