Effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive impairment in depression: A systematic review and meta-analysis

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders Pub Date : 2025-01-08 DOI:10.1016/j.jad.2025.01.014

Lirong Fu , Juanjuan Ren , Xiaoxia Lei , Rong Zhang , Chen Zhang

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引用次数: 0

Abstract

Objective

Cognitive dysfunction is a core symptom of depression and contributes significantly to functional and psychosocial impairment. However, pharmacotherapy has shown limited efficacy in alleviating these cognitive deficits. This study aimed to systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in improving cognitive impairments in patients with depression.

Methods

A literature search was conducted across PubMed, Embase, Web of Science, PsycINFO, and the Cochrane Library databases up to June 19, 2024. Studies were included if they met the following criteria: (1) participants were exclusively patients with unipolar depression, (2) both active rTMS and sham stimulation were administered in parallel groups, (3) sufficient data were available, and (4) the study design was a randomized controlled trial (RCT).

Results

A total of 15 studies met the inclusion criteria. The meta-analysis revealed no significant improvement in cognitive impairment with active rTMS compared to sham rTMS across multiple cognitive domains, including global cognitive function, attention, working memory, psychomotor speed, language, visuospatial ability, learning and memory, and executive function.

Conclusion

Current evidence suggests that rTMS does not demonstrate substantial efficacy in alleviating cognitive dysfunction in patients with depression. Future research should focus on elucidating the underlying mechanisms of rTMS efficacy and optimizing stimulation protocols, including the precise targeting of stimulation sites, as well as refining frequency, intensity, and duration parameters to better address cognitive impairment.

查看原文本刊更多论文

重复经颅磁刺激（rTMS）对抑郁症患者认知功能障碍的影响：系统回顾和荟萃分析。

目的：认知功能障碍是抑郁症的核心症状，是导致功能和心理障碍的重要因素。然而，药物治疗在缓解这些认知缺陷方面的疗效有限。本研究旨在系统评价重复经颅磁刺激（rTMS）对抑郁症患者认知功能障碍的改善效果。方法：通过PubMed、Embase、Web of Science、PsycINFO和Cochrane Library数据库进行文献检索，检索截止到2024年6月19日。符合以下标准的研究被纳入：(1)参与者完全是单极抑郁症患者，(2)主动rTMS和假刺激在平行组中进行，(3)有足够的数据可用，(4)研究设计为随机对照试验（RCT）。结果：共有15项研究符合纳入标准。荟萃分析显示，与假rTMS相比，活动rTMS在多个认知领域的认知障碍没有显著改善，包括全球认知功能、注意力、工作记忆、精神运动速度、语言、视觉空间能力、学习记忆和执行功能。结论：目前的证据表明，rTMS在缓解抑郁症患者认知功能障碍方面并没有显示出实质性的疗效。未来的研究应侧重于阐明rTMS疗效的潜在机制和优化刺激方案，包括精确靶向刺激部位，以及改进频率、强度和持续时间参数，以更好地解决认知障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.