SYSTEMATIC REVIEW article
Front. Aging Neurosci.
Sec. Parkinson’s Disease and Aging-related Movement Disorders
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1623917
This article is part of the Research TopicBrain stimulation for cognitive impairments in psychiatric and neurodegenerative disordersView all 4 articles
Effects of different frequencies of repetitive transcranial magnetic stimulation on sleep disorders and depression in patients with Parkinson's disease: a systematic review and network meta-analysis
Provisionally accepted
- 1Hubei Rehabilitation Hospita, WU HAN, China
- 2Beijing Jishuitan Hospital Guizhou Hospital, Guizhou Provincial Orthopedics Hospital,, Gui yang, China
- 3School of Public Finance and Taxation, Central University of Finance and Economics,, Bei jing, China
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Background:Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising neuromodulatory approach for alleviating sleep disturbances and depressive symptoms in Parkinson's disease (PD), yet direct comparisons of different stimulation frequencies remain scarce.Objective: To evaluate and rank the efficacy of three rTMS frequencies (1 Hz, 5 Hz, and 10 Hz), each combined with conventional therapy, on sleep disorders and depression in PD patients, thereby informing clinical decision-making.Methods: We conducted a systematic search for randomized controlled trials (RCTs) in PubMed, Embase, the Cochrane Library, Web of Science, ProQuest, China National Knowledge Infrastructure, Wanfang, and the Chinese Scientific and Journal Database. A network meta-analysis was performed to compare the effects of different frequencies of rTMS (1Hz, 5Hz and 10Hz) on sleep disorders and depression in PD patients.Results: Thirty-one RCTs involving 1,977 PD patients met inclusion criteria. Compared with conventional treatment alone, adjunctive 5 Hz and 10 Hz rTMS produced significant improvements in bothPittsburgh Sleep Quality Index(PSQI) and Parkinson's Disease Sleep Scale (PDSS). Although 1 Hz rTMS yielded numerically greater PSQI and PDSS improvements than conventional therapy, these differences did not reach statistical significance, nor did differences between the three stimulation frequencies. In terms of depressive symptoms, all three frequencies (1 Hz, 5 Hz, and 10 Hz) significantly reduced HAMD scores versus standard care, with head-to-head comparisons indicating superior efficacy of 10 Hz over 1 Hz and 5 Hz. The Surface Under the Cumulative Ranking area (SUCRA)consistently identified 10 Hz rTMS as the most effective frequency for PSQI, PDSS, and HAMD outcomes.Conclusions: Adjunctive rTMS at 1 Hz, 5 Hz, and 10 Hz each confer benefits for sleep and mood in PD patients, but 10 Hz stimulation appears to offer the greatest overall improvement. These findings support the preferential use of 10 Hz rTMS when targeting non-motor symptoms in Parkinson's disease.
Keywords: Parkinson, sleep disorder, Depression, repetitive transcranial magnetic stimulation, metaanalysis
Received: 07 May 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Xia, Li, Wan, Hu and SUN. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenhui SUN, School of Public Finance and Taxation, Central University of Finance and Economics,, Bei jing, China
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