The effect of transcranial magnetic stimulation on the recovery of attention and memory impairment following stroke: a systematic review and meta-analysis

Expert Rev Neurother. 2022 Nov-Dec;22(11-12):1031-1041. doi: 10.1080/14737175.2022.2155515. Epub 2022 Dec 16.

Abstract

Background: Previous studies indicated inconsistent results for the treatment effect of repetitive transcranial magnetic stimulation (rTMS) on attention and memory impairment following stroke.

Methods: Randomized controlled trials (RCTs) on TMS for the treatment of stroke were retrieved from Online databases. Data were analyzed by RevMan 5.3 software.

Results: Ten RCTs performed in China were included, with a total of 591 younger post-stroke patients ranging in age from their 40s to their 60s. The meta-analysis indicated that TMS could significantly improve the recovery of cognitive impairment following a stroke, according to the Montreal Cognitive Assessment (MoCA) score (8 studies, MD = 2.69, 95% CI: 1.44 to 3.95, P < 0.0001), the Rivermead Behavioral Memory Test (RBMT) score (7 studies, MD = 1.74, 95% CI:1.13 to 2.34, P < 0.00001), and the Modified Barthel Index (MBI) for Activities of Daily Living (3 studies, MD = 8.83, 95% CI:5.34 to 12.32, P < 0.00001). Sub-group analysis of MoCA and RBMT suggested that a low-frequency (1 Hz) stimulation exhibited similar effect with a higher-frequency (10 Hz) treatment.

Discussion: TMS might effectively improve the attention and memory impairment of stroke patients without increasing side effects. But this effect needs to be verified by more multi-center, high-quality, large-sample, rigorously designed RCTs.

Keywords: Attention impairment; memory impairment; meta-analysis; transcranial magnetic stimulation (TMS).

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attention
  • Cognitive Dysfunction* / etiology
  • Humans
  • Memory Disorders / etiology
  • Stroke Rehabilitation*
  • Stroke* / complications
  • Stroke* / therapy
  • Transcranial Magnetic Stimulation / methods