AUTHOR=Wei Zhenyu , Fu Jiaqi , Liang Huazheng , Liu Mingli , Ye Xiaofei , Zhong Ping 

TITLE=The therapeutic efficacy of transcranial magnetic stimulation in managing Alzheimer’s disease: A systemic review and meta-analysis

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 14 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.980998

DOI=10.3389/fnagi.2022.980998

ISSN=1663-4365

ABSTRACT=Background: Repetitive Transcranial Magnetic Stimulation (rTMS) is widely used to treat Alzheimer's Disease. However, the effect of rTMS is still controversial. The purpose of the present study is to evaluate the effectiveness of rTMS on cognitive performance of AD patients.
Methods: We systematically searched relevant literatures in four major databases - PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials [Central] before April 2022. Both randomized controlled trials and cross-section studies that compared the therapeutic effect of rTMS with blank control or sham stimuli were included.
Results: A total of 14 studies involving 513 AD patients were finally included for meta-analysis. It was found that rTMS significantly improved global cognitive function (SMD=0.24, 95%CI, 0.12 to 0.36, P=0.0001) and daily living ability (IADL: SMD=0.64, 95%CI, 0.21to 1.08, P =0.004) in patients with AD, but did not show improvement in language, memory, executive ability, and mood. In subgroup analyses, 20 Hz, rTMS on a single target, and 20 sessions of treatment were shown to produce a positive effect. In addition, improvement in cognitive functions lasted for at least 6 weeks (SMD=0.67, 95%CI, 0.05to 1.30,P=0.04). 
Conclusions: rTMS can improve the global cognition and daily living ability of AD patients. Given the relatively small sample size, our results on subgroup analysis should be interpreted with caution. Studies with larger sample sizes and longer follow-up are needed to better assess the efficacy of rTMS in the management of AD patients and the optimal type of stimulation required to maximize beneficial outcomes.