Systematic review and meta-analysis of repetitive transcranial magnetic stimulation (rTMS) for activities of daily living in Alzheimer's disease

Author: Yufei Hou1, Fang Liu2, Nan Lin3, Shan Gao1
Affiliation: <sup>1</sup> College of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, Fujian, China. <sup>2</sup> College of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, Fujian, China. liufangcn05@163.com. <sup>3</sup> College of Acupuncture and Massage, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, Fujian, China.
Conference/Journal: Neurol Sci
Date published: 2024 Jul 23
Other: Special Notes: doi: 10.1007/s10072-024-07709-z. , Word Count: 250


Objective:
This systematic review of randomised controlled trials (RCTs) was conducted to assess the effect of repetitive transcranial magnetic stimulation (rTMS) on activities of daily living (ADLs) in Alzheimer's disease (AD) patients.

Data sources:
Ten databases were retrieved for pertinent Chinese and English literatures published up until January 2024.

Review methods:
All RCTs of rTMS for ADLs in AD were included in this meta-analysis. Two researchers independently selected the literatures, retrieved the data of included literatures, accessed risk-of-bias of literatures with the Cochrane Collaboration's quality criteria and then cross-checked. Meta-analysis was carried out with Cochrane's Review Manager (RevMan, version 5.4). The PRISMA guidelines were followed in this systematic review.

Results:
The 37 literatures involving 2461 patients with AD were included in this study. Compared with the control groups received the interventions such as routine pharmacotherapy, cognitive training, ect., with/without sham-rTMS, the experiment groups received the interventions of the control groups and rTMS. The findings were as follows: ADL scale [mean difference (MD) = -3.92, 95%CI (-4.93, -2.91), P < 0.00001]; Barthel Index (BI) [MD = 9.75, 95% CI (6.66, 12.85), P < 0.00001]; Modified Barthel Index (MBI) [MD = 5.43, 95% CI (3.13, 7.73), P < 0.00001]. The differences were statistically significant for all indicators. In 29 studies, rTMS stimulation sites were located in the dorsolateral prefrontal cortex (DLPFC).

Conclusion:
The rTMS could improve the ADLs in AD patients, and the DLPFC was a frequently used stimulation site of the rTMS for AD treatment.

Keywords: Activities of daily living; Alzheimer's disease; Meta-analysis; Randomised controlled trials; Repetitive transcranial magnetic stimulation (rTMS); Systematic review.

PMID: 39044102 DOI: 10.1007/s10072-024-07709-z