Efficacy of Repetitive Transcranial Magnetic Stimulation on Patients with Mild Cognitive Impairment: A Systematic Review and Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 WANGMeng ,  PANXiao-pin , DENGWei-hua , YANGYong , ChenShu-da , HURong , CHENXi , CAIZhuo-yi

Neurology Department, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, China;

Corresponding author：

PANXiao-pin, Email: qpanxp@163.com

Keywords：

Repetitive transcranial magnetic stimulation; Mild cognitive impairment; Randomized controlled trial; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.20150228

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the efficacy of repetitive transcranial magnetic stimulation (rTMS) on patients with mild cognitive impairment (MCI). Methods We searched databases including PubMed, The Cochrane Library (Issue 10, 2015), EMbase, PsycINF, EBSCO, CBM, CNKI, WanFang Data and VIP from inception to October 2015 to collect randomized controlled trials (RCTs) about rTMS for patients with MCI. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. Results A total of 5 RCTs involving 180 MCI patients were included. The results of meta-analysis showed that, compared with the control group, rTMS treatment could significantly improve the overall cognitive abilities of MCI patients (SMD=2.53, 95% CI 0.91 to 4.16, P=0.002), as well as the single-domain cognitive performances, including tests for episodic memory (MD=0.98, 95% CI 0.24 to 1.72, P=0.01) and verbal fluency (MD=2.08, 95% CI 0.46 to 3.69, P=0.01). rTMS was a well-tolerated therapy, with slightly more adverse events observed than the control group (RD=0.09, 95% CI 0.00 to 0.18, P=0.04), but cases were mainly transient headache, dizziness and scalp pain. Conclusion rTMS may benefit the cognitive abilities of MCI patients. Nevertheless, due to the limited quantity and quality of included studies, large-scale, multicenter, and high quality RCTs are required to verify the conclusion.

Citation： WANGMeng, PANXiao-pin, DENGWei-hua, YANGYong, ChenShu-da, HURong, CHENXi, CAIZhuo-yi. Efficacy of Repetitive Transcranial Magnetic Stimulation on Patients with Mild Cognitive Impairment: A Systematic Review and Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(12): 1393-1400. doi: 10.7507/1672-2531.20150228 Copy

1.	Jia J, Zhou A, Wei C, et al. The prevalence of mild cognitive impairment and its etiological subtypes in elderly Chinese. Alzheimers Dement, 2014, 10(4):439-447.
2.	Manly JJ, Tang MX, Schupf N, et al. Frequency and course of mild cognitive impairment in a multiethnic community. Ann Neurol, 2008, 63(4):494-506.
3.	de Bruijn RF, Akoudad S, Cremers LG, et al. Determinants, MRI correlates, and prognosis of mild cognitive impairment:the Rotterdam Study. J Alzheimers Dis, 2014, 42 (Suppl 3):S239-249.
4.	Cho SS, Strafella AP. rTMS of the left dorsolateral prefrontal cortex modulates dopamine release in the ipsilateral anterior cingulate cortex and orbitofrontal cortex. PLoS One, 2009, 4(8):e6725.
5.	Fox MD, Buckner RL, White MP, et al. Efficacy of Transcranial Magnetic Stimulation Targets for Depression Is Related to Intrinsic Functional Connectivity with the Subgenual Cingulate. Biol Psychiatry, 2012, 72(7):595-603.
6.	Hoogendam JM, Ramakers GM, Di Lazzaro V. Physiology of repetitive transcranial magnetic stimulation of the human brain. Brain Stimul, 2010, 3(2):95-118.
7.	Winblad B, Palmer K, Kivipelto M, et al. Mild cognitive impairment——beyond controversies, towards a consensus:report of the International Working Group on Mild Cognitive Impairment. J Intern Med, 2004, 256(3):240-246.
8.	Portet, F, Ousset PJ, Visser PJ, et al. Mild cognitive impairment (MCI) in medical practice:a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease. J Neurol Neurosurg Psychiatry, 2006, 77(6):714-718.
9.	Petersen RC, Smith GE, Waring SC, et al. Mild cognitive impairment:clinical characterization and outcome. Arch Neurol, 1999, 56(3):303-308.
10.	中国防治认知功能障碍专家共识专家组. 中国防治认知功能障碍专家共识. 中华内科杂志, 2006, 45(2):171-173.
11.	Drumond Marra HL, Myczkowski ML, Maia Memória C, et al. Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly:A Randomized Controlled Study. Behav Neurol, 2015, 2015:287843.
12.	杨林霖, 韩克艳, 王学义, 等. 高频重复经颅磁刺激改善轻度认知障碍患者认知功能的初步分析. 中华精神科杂志, 2014, 47(4): 227-231.
13.	韩克艳, 于鲁璐, 王岚, 等. 重复经颅磁刺激对老年人轻度认知损害影响的对照研究. 临床精神医学杂志, 2013, 23(3):156-159.
14.	闰丽丽, 陶华英. 重复经颅磁刺激对轻度认知功能障碍患者极易功能改善作用的研究. 中华老年心脑血管病杂志, 2011, 13(5): 438-441.
15.	章礼勇, 袁良津, 王玉. 重复经颅磁刺激第轻度认知功能障碍患者认知功能的影响. 临床神经病学杂志, 2014, 27(3):203-206.
16.	Grober E, Lipton R, Hall C, et al. Memory impairment on free and cued selective reminding predicts dementia. Neurology, 2000, 54(4): 827-832.
17.	Anderkova L, Rektorova I. Cognitive effects of repetitive transcranial magnetic stimulation in patients with neurodegenerative diseases-clinician's perspective. J Neurol Sci, 2014, 339(1-2):15-25.
18.	Ohsugi H, Ohgi S, Shigemori K, et al. Differences in dual-task performance and prefrontal cortex activation between younger and older adults. BMC Neurosci, 2013, 14, 10(10):e0140552.
19.	Fried PJ, Rushmore RJ, Moss MB, et al. Causal evidence supporting functional dissociation of verbal and spatial working memory in the human dorsolateral prefrontal cortex. Eur J Neurosci, 2014, 39(11): 1973-1981.
20.	Blumenfeld RS, Lee TG, D'Esposito M. The Effects of Lateral Prefrontal Transcranial Magnetic Stimulation on Item Memory Encoding. Neuropsychologia, 2014, 53:197-202.
21.	Cooper NR, Fitzgerald PB, Croft RJ, et al. Effects of rTMS on an auditory oddball task:a pilot study of cortical plasticity and the EEG. Clin EEG Neurosci, 2008, 39(3):139-143.
22.	Lefaucheur JP, André-Obadia N, Antal A, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol, 2014, 125(11):2150-2206.
23.	Rossi S, Hallett M, RossiniPM, et al. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol, 2009, 120(12):2008-2039.
24.	Wassermann EM. Risk and safety of repetitive transcranial magnetic stimulation:report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation. Electroencephalogr Clin Neurophysiol, 1998, 108(1): 1-16.
25.	Ahmed MA, Darwish E, Khedr EM, et al. Effects of low versus high frequencies of repetitive transcranial magnetic stimulation on cognitive function and cortical excitability in Alzheimer's dementia. J Neurol, 2012, 259(1):83-92.
26.	Zanetti O, Vallotti B, Frisoni GB, et al. Insight in dementia:when does it occur? Evidence for a nonlinear relationship between insight and cognitive status. J Gerontol B Psychol Sci Soc Sci, 1999, 54(2): 100-106.
27.	Franco-Marina F, García-González JJ, Wagner-Echeagaray F, et al. The Mini-mental State Examination revisited:ceiling and floor effects after score adjustment for educational level in an aging Mexican population. Int Psychogeriatr, 2010, 22(1):72-78.
28.	Gainotti G, Quaranta D, Vita MG, et al. Neuropsychological predictors of conversion from mild cognitive impairment to Alzheimer's disease. J Alzheimers Dis. 2014, 38(3):481-495.

1. Jia J, Zhou A, Wei C, et al. The prevalence of mild cognitive impairment and its etiological subtypes in elderly Chinese. Alzheimers Dement, 2014, 10(4):439-447.
2. Manly JJ, Tang MX, Schupf N, et al. Frequency and course of mild cognitive impairment in a multiethnic community. Ann Neurol, 2008, 63(4):494-506.
3. de Bruijn RF, Akoudad S, Cremers LG, et al. Determinants, MRI correlates, and prognosis of mild cognitive impairment:the Rotterdam Study. J Alzheimers Dis, 2014, 42 (Suppl 3):S239-249.
4. Cho SS, Strafella AP. rTMS of the left dorsolateral prefrontal cortex modulates dopamine release in the ipsilateral anterior cingulate cortex and orbitofrontal cortex. PLoS One, 2009, 4(8):e6725.
5. Fox MD, Buckner RL, White MP, et al. Efficacy of Transcranial Magnetic Stimulation Targets for Depression Is Related to Intrinsic Functional Connectivity with the Subgenual Cingulate. Biol Psychiatry, 2012, 72(7):595-603.
6. Hoogendam JM, Ramakers GM, Di Lazzaro V. Physiology of repetitive transcranial magnetic stimulation of the human brain. Brain Stimul, 2010, 3(2):95-118.
7. Winblad B, Palmer K, Kivipelto M, et al. Mild cognitive impairment——beyond controversies, towards a consensus:report of the International Working Group on Mild Cognitive Impairment. J Intern Med, 2004, 256(3):240-246.
8. Portet, F, Ousset PJ, Visser PJ, et al. Mild cognitive impairment (MCI) in medical practice:a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease. J Neurol Neurosurg Psychiatry, 2006, 77(6):714-718.
9. Petersen RC, Smith GE, Waring SC, et al. Mild cognitive impairment:clinical characterization and outcome. Arch Neurol, 1999, 56(3):303-308.
10. 中国防治认知功能障碍专家共识专家组. 中国防治认知功能障碍专家共识. 中华内科杂志, 2006, 45(2):171-173.
11. Drumond Marra HL, Myczkowski ML, Maia Memória C, et al. Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly:A Randomized Controlled Study. Behav Neurol, 2015, 2015:287843.
12. 杨林霖, 韩克艳, 王学义, 等. 高频重复经颅磁刺激改善轻度认知障碍患者认知功能的初步分析. 中华精神科杂志, 2014, 47(4): 227-231.
13. 韩克艳, 于鲁璐, 王岚, 等. 重复经颅磁刺激对老年人轻度认知损害影响的对照研究. 临床精神医学杂志, 2013, 23(3):156-159.
14. 闰丽丽, 陶华英. 重复经颅磁刺激对轻度认知功能障碍患者极易功能改善作用的研究. 中华老年心脑血管病杂志, 2011, 13(5): 438-441.
15. 章礼勇, 袁良津, 王玉. 重复经颅磁刺激第轻度认知功能障碍患者认知功能的影响. 临床神经病学杂志, 2014, 27(3):203-206.
16. Grober E, Lipton R, Hall C, et al. Memory impairment on free and cued selective reminding predicts dementia. Neurology, 2000, 54(4): 827-832.
17. Anderkova L, Rektorova I. Cognitive effects of repetitive transcranial magnetic stimulation in patients with neurodegenerative diseases-clinician's perspective. J Neurol Sci, 2014, 339(1-2):15-25.
18. Ohsugi H, Ohgi S, Shigemori K, et al. Differences in dual-task performance and prefrontal cortex activation between younger and older adults. BMC Neurosci, 2013, 14, 10(10):e0140552.
19. Fried PJ, Rushmore RJ, Moss MB, et al. Causal evidence supporting functional dissociation of verbal and spatial working memory in the human dorsolateral prefrontal cortex. Eur J Neurosci, 2014, 39(11): 1973-1981.
20. Blumenfeld RS, Lee TG, D'Esposito M. The Effects of Lateral Prefrontal Transcranial Magnetic Stimulation on Item Memory Encoding. Neuropsychologia, 2014, 53:197-202.
21. Cooper NR, Fitzgerald PB, Croft RJ, et al. Effects of rTMS on an auditory oddball task:a pilot study of cortical plasticity and the EEG. Clin EEG Neurosci, 2008, 39(3):139-143.
22. Lefaucheur JP, André-Obadia N, Antal A, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol, 2014, 125(11):2150-2206.
23. Rossi S, Hallett M, RossiniPM, et al. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol, 2009, 120(12):2008-2039.
24. Wassermann EM. Risk and safety of repetitive transcranial magnetic stimulation:report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation. Electroencephalogr Clin Neurophysiol, 1998, 108(1): 1-16.
25. Ahmed MA, Darwish E, Khedr EM, et al. Effects of low versus high frequencies of repetitive transcranial magnetic stimulation on cognitive function and cortical excitability in Alzheimer's dementia. J Neurol, 2012, 259(1):83-92.
26. Zanetti O, Vallotti B, Frisoni GB, et al. Insight in dementia:when does it occur? Evidence for a nonlinear relationship between insight and cognitive status. J Gerontol B Psychol Sci Soc Sci, 1999, 54(2): 100-106.
27. Franco-Marina F, García-González JJ, Wagner-Echeagaray F, et al. The Mini-mental State Examination revisited:ceiling and floor effects after score adjustment for educational level in an aging Mexican population. Int Psychogeriatr, 2010, 22(1):72-78.
28. Gainotti G, Quaranta D, Vita MG, et al. Neuropsychological predictors of conversion from mild cognitive impairment to Alzheimer's disease. J Alzheimers Dis. 2014, 38(3):481-495.

Chinese Journal of Evidence-Based Medicine

Efficacy of Repetitive Transcranial Magnetic Stimulation on Patients with Mild Cognitive Impairment: A Systematic Review and Meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content