Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions—A Systematic Review
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique also used as a non-pharmacological intervention against cognitive impairment. The purpose of the present review was to summarize what is currently known about the effectiveness of rTMS intervention on d...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/19/6190 |
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| author | Minoo Sharbafshaaer Ilaria Gigi Luigi Lavorgna Sabrina Esposito Simona Bonavita Gioacchino Tedeschi Fabrizio Esposito Francesca Trojsi |
| author_facet | Minoo Sharbafshaaer Ilaria Gigi Luigi Lavorgna Sabrina Esposito Simona Bonavita Gioacchino Tedeschi Fabrizio Esposito Francesca Trojsi |
| author_sort | Minoo Sharbafshaaer |
| collection | DOAJ |
| description | Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique also used as a non-pharmacological intervention against cognitive impairment. The purpose of the present review was to summarize what is currently known about the effectiveness of rTMS intervention on different cognitive domains in patients with mild cognitive impairment (MCI) and to address potential neuromodulation approaches in combination with electroencephalography (EEG) and neuroimaging, especially functional magnetic resonance imaging (fMRI). In this systematic review, we consulted three main databases (PubMed, Science Direct, and Scopus), and Google Scholar was selected for the gray literature search. The PRISMA flowchart drove the studies’ inclusion. The selection process ensured that only high-quality studies were included; after removing duplicate papers, explicit ratings were given based on the quality classification as high (A), moderate (B), or low (C), considering factors such as risks of bias, inaccuracies, inconsistencies, lack of direction, and publication bias. Seven full-text articles fulfilled the stated inclusion, reporting five double-blind, randomized, sham-controlled studies, a case study, and a randomized crossover trial. The results of the reviewed studies suggested that rTMS in MCI patients is safe and effective for enhancing cognitive functions, thus making it a potential therapeutic approach for MCI patients. Changes in functional connectivity within the default mode network (DMN) after targeted rTMS could represent a valuable indicator of treatment response. Finally, high-frequency rTMS over the dorsolateral prefrontal cortex (DLPFC) has been shown to significantly enhance cognitive functions, such as executive performance, together with the increase of functional connectivity within frontoparietal networks. The main limitations were the number of included studies and the exclusion of studies using intermittent theta-burst stimulation, used in studies on Alzheimer’s disease. Therefore, neuroimaging techniques in combination with rTMS have been shown to be useful for future network-based, fMRI-guided therapeutic approaches. |
| first_indexed | 2024-03-10T21:41:59Z |
| format | Article |
| id | doaj.art-a920efcec9a34a4e920e79d5a670c61a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:41:59Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a920efcec9a34a4e920e79d5a670c61a2023-11-19T14:35:21ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011219619010.3390/jcm12196190Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions—A Systematic ReviewMinoo Sharbafshaaer0Ilaria Gigi1Luigi Lavorgna2Sabrina Esposito3Simona Bonavita4Gioacchino Tedeschi5Fabrizio Esposito6Francesca Trojsi7MRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, ItalyMRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, ItalyFirst Division of Neurology, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, ItalyFirst Division of Neurology, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, ItalyMRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, ItalyMRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, ItalyMRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, ItalyMRI Research Center, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, ItalyRepetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique also used as a non-pharmacological intervention against cognitive impairment. The purpose of the present review was to summarize what is currently known about the effectiveness of rTMS intervention on different cognitive domains in patients with mild cognitive impairment (MCI) and to address potential neuromodulation approaches in combination with electroencephalography (EEG) and neuroimaging, especially functional magnetic resonance imaging (fMRI). In this systematic review, we consulted three main databases (PubMed, Science Direct, and Scopus), and Google Scholar was selected for the gray literature search. The PRISMA flowchart drove the studies’ inclusion. The selection process ensured that only high-quality studies were included; after removing duplicate papers, explicit ratings were given based on the quality classification as high (A), moderate (B), or low (C), considering factors such as risks of bias, inaccuracies, inconsistencies, lack of direction, and publication bias. Seven full-text articles fulfilled the stated inclusion, reporting five double-blind, randomized, sham-controlled studies, a case study, and a randomized crossover trial. The results of the reviewed studies suggested that rTMS in MCI patients is safe and effective for enhancing cognitive functions, thus making it a potential therapeutic approach for MCI patients. Changes in functional connectivity within the default mode network (DMN) after targeted rTMS could represent a valuable indicator of treatment response. Finally, high-frequency rTMS over the dorsolateral prefrontal cortex (DLPFC) has been shown to significantly enhance cognitive functions, such as executive performance, together with the increase of functional connectivity within frontoparietal networks. The main limitations were the number of included studies and the exclusion of studies using intermittent theta-burst stimulation, used in studies on Alzheimer’s disease. Therefore, neuroimaging techniques in combination with rTMS have been shown to be useful for future network-based, fMRI-guided therapeutic approaches.https://www.mdpi.com/2077-0383/12/19/6190mild cognitive impairmentrepetitive transcranial magnetic stimulationEEGfunctional magnetic resonance imagingneuroplasticity |
| spellingShingle | Minoo Sharbafshaaer Ilaria Gigi Luigi Lavorgna Sabrina Esposito Simona Bonavita Gioacchino Tedeschi Fabrizio Esposito Francesca Trojsi Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions—A Systematic Review Journal of Clinical Medicine mild cognitive impairment repetitive transcranial magnetic stimulation EEG functional magnetic resonance imaging neuroplasticity |
| title | Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions—A Systematic Review |
| title_full | Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions—A Systematic Review |
| title_fullStr | Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions—A Systematic Review |
| title_full_unstemmed | Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions—A Systematic Review |
| title_short | Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions—A Systematic Review |
| title_sort | repetitive transcranial magnetic stimulation rtms in mild cognitive impairment effects on cognitive functions a systematic review |
| topic | mild cognitive impairment repetitive transcranial magnetic stimulation EEG functional magnetic resonance imaging neuroplasticity |
| url | https://www.mdpi.com/2077-0383/12/19/6190 |
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