Impact of repetitive transcranial magnetic stimulation on cognitive impairment in stroke patients: A meta-analysis of randomized controlled trials.

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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI:10.1016/j.jstrokecerebrovasdis.2025.108415

Zhi-Qiang Zhao, Huai-Nan Li, Yun Ye, Jun-Lin Wang, Peng Xu

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Abstract

Objective: To evaluate the impact of repetitive transcranial magnetic stimulation (rTMS) on cognitive impairment in stroke patients using meta-analysis.

Methods: Electronic databases (PubMed, Web of Science, Cochrane Library, and Embase) were systematically searched up to October 20, 2024. Randomized controlled trials assessing the effect of rTMS on cognitive impairment in stroke patients were included. Pooled effect sizes were calculated using standardized mean differences (SMD) or mean differences (MD) based on fixed or random effects models.

Results: Fourteen studies involving 597 stroke patients were included in this meta-analysis. The results showed that rTMS significantly improved global cognitive function in stroke patients (SMD: 0.54; 95 % CI: 0.28, 0.79), particularly with high-intensity rTMS (SMD: 0.41; 95 % CI: 0.07, 0.76) and intermittent theta-burst stimulation (iTBS) (SMD: 0.94; 95 % CI: 0.62, 1.27). In terms of different rating scales, rTMS significantly increased scores on the Modified Barthel Index (MBI) (MD: 10.54; 95 % CI: 4.85, 16.23) and the Montreal Cognitive Assessment (MoCA) (MD: 1.96; 95 % CI: 0.91, 3.01), while the effects on the Mini-Mental State Examination (MMSE), Rivermead Behavioral Memory Test (RBMT), and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were not statistically significant.

Conclusion: This meta-analysis confirms that rTMS can effectively improve cognitive function in stroke patients. However, due to the limited number of studies included, further high-quality research is needed to substantiate our findings.

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反复经颅磁刺激对脑卒中患者认知功能障碍的影响：随机对照试验的荟萃分析。

目的：采用meta分析方法评价重复经颅磁刺激（rTMS）对脑卒中患者认知功能障碍的影响。方法：系统检索截至2024年10月20日的电子数据库（PubMed、Web of Science、Cochrane Library和Embase）。随机对照试验评估rTMS对脑卒中患者认知功能障碍的影响。采用基于固定或随机效应模型的标准化平均差异（SMD）或平均差异（MD）计算合并效应大小。结果：本荟萃分析纳入了14项研究，涉及597例脑卒中患者。结果显示，rTMS可显著改善脑卒中患者的整体认知功能(SMD: 0.54；95% CI: 0.28, 0.79)，特别是高强度rTMS (SMD: 0.41；95% CI: 0.07, 0.76)和间歇性脉冲刺激（iTBS） (SMD: 0.94；95% ci: 0.62, 1.27)。在不同评定量表上，rTMS显著提高了修正Barthel指数（MBI）得分(MD: 10.54；95% CI: 4.85, 16.23)和蒙特利尔认知评估（MoCA） (MD: 1.96；95% CI: 0.91, 3.01)，而对迷你精神状态检查（MMSE）， Rivermead行为记忆测试（RBMT）和Loewenstein职业治疗认知评估（LOTCA）的影响无统计学意义。结论：本荟萃分析证实rTMS可有效改善脑卒中患者的认知功能。然而，由于纳入的研究数量有限，需要进一步的高质量研究来证实我们的发现。

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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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

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