A systematic review and meta-analysis of rTMS effects on cognitive enhancement in mild cognitive impairment and Alzheimer's disease
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Repetitive transcranial magnetic stimulation (rTMS), a noninvasive brain stimulation technique, has emerged as a promising treatment for mild cognitive impairment (MCI) and Alzheimer's disease (AD). Currently, however, the effectiveness of this therapy is unclear because of the low statistical power and heterogeneity of previous trials. The purpose of the meta-analysis was to systematically characterize the effectiveness of various combinations of rTMS parameters on different cognitive domains in patients with MCI and AD. Thirteen studies comprising 293 patients with MCI or AD were included in this analysis. Random-effects analysis revealed an overall medium-to-large effect size (0.77) favoring active rTMS over sham rTMS in the improvement of cognitive functions. Subgroup analyses revealed that (1) high-frequency rTMS over the left dorsolateral prefrontal cortex and low-frequency rTMS at the right dorsolateral prefrontal cortex significantly improved memory functions; (2) high-frequency rTMS targeting the right inferior frontal gyrus significantly enhanced executive performance; and (3) the effects of 5-30 consecutive rTMS sessions could last for 4-12 weeks. Potential mechanisms of rTMS effects on cognitive functions are discussed.
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Evidence supports pro-cognitive effects of TMS in healthy individuals and in patients with neurologic and psychiatric illnesses such as mild to moderate Alzheimer's disease, mild cognitive impairment, stroke, schizophrenia, and bipolar disorder.
“Evidence supports the pro-cognitive effects of TMS in healthy individuals (Luber & Lisanby, 2014) and in patients with neurologic and psychiatric illnesses such as mild to moderate Alzheimer's disease (Cheng et al., 2018;Chou et al., 2020;Lin et al., 2019;Wang et al., 2020), mild cognitive impairment (MCI; Chou et al., 2020;Drumond Marra et al., 2015;Jiang et al., 2021), stroke (M.Liu et al., 2021”
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 Chou et al., 2020
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- Authors
- Chou, Y.-H., Ton That, V., & Sundman, M.
- Affiliations
- University of Arizona (US)
- Corresponding author
- Chou, Ying-hui
- Venue
- Neurobiology of Aging
- Publisher
- Elsevier BV
- Published
- 2020-02
- Volume
- 86
- Pages
- 1-10
- ISSN
- 0197-4580 (ISSN-L)
- PMC
- PMC6995441
- OpenAlex
- W2970043376
- Cited by
- 319
- References
- 104
- Citations by year
- 2026: 34 · 2025: 66 · 2024: 62 · 2023: 51 · 2022: 47 · 2021: 51 · 2020: 8
- FWCI
- 2.79
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Neurobiology of Aging (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Arizona
- Shell United States (PI: Y-hC)
- National Institutes of Health (Y-hC)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- repetitive transcranial magnetic stimulation, mild cognitive impairment, Alzheimer's disease, cognitive enhancement, high-frequency rTMS, low-frequency rTMS, dorsolateral prefrontal cortex, inferior frontal gyrus, memory, executive function, treatment duration
- MeSH terms
- Alzheimer Disease, Cognition, Humans, Memory, Prefrontal Cortex, Transcranial Magnetic Stimulation, Cognitive Dysfunction
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.
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