Abstract
BackgroundTo evaluate the effects and optimal parameters of repetitive transcranial magnetic stimulation (rTMS) on cognition function of patients with Parkinson’s disease (PD) and to estimate which cognitive function may obtain more benefits from rTMS.MethodThe articles dealing with rTMS on cognitive function of PD patients were retrieved from the databases until April 2019. Outcomes of global cognitive function and different cognitive domains were extracted. The standardized mean differences (SMDs) with 95% confidence interval (CI) of cognitive outcome for different parameters, scales, and cognitive functions were estimated.ResultsFourteen studies involving 173 subjects were included in this meta-analysis. A significant effect size was observed with the mini-mental state examination (MMSE) for the global cognitive outcome based on the evidence of four published articles. Further subtests for different cognitive domains demonstrated prominent effect for the executive function. The significant effect sizes for executive function were found with multiple sessions of high-frequency rTMS over frontal cortex; especially over dorsolateral prefrontal cortex (DLPFC). All of the other cognitive domains, which included memory, attention, and language ability, did not obtain significant effects.ConclusionsMultiple sessions of high-frequency rTMS over the DLPFC may have positive effect on executive function in PD patients. Further well designed studies with large sample sizes are needed to verify our results and ascertain the long-term effects of rTMS.
Highlights
To evaluate the effects and optimal parameters of repetitive transcranial magnetic stimulation on cognition function of patients with Parkinson’s disease (PD) and to estimate which cognitive function may obtain more benefits from rTMS
A significant effect size was observed with the mini-mental state examination (MMSE) for the global cognitive outcome based on the evidence of four published articles
The significant effect sizes for executive function were found with multiple sessions of highfrequency rTMS over frontal cortex; especially over dorsolateral prefrontal cortex (DLPFC)
Summary
To evaluate the effects and optimal parameters of repetitive transcranial magnetic stimulation (rTMS) on cognition function of patients with Parkinson’s disease (PD) and to estimate which cognitive function may obtain more benefits from rTMS. Due to the lack of understanding and neglect of the physiological processes mediating cognitive changes by clinicians, the underlying pathogenesis and mechanism of cognitive deficit in PD patients are still unclear, but they are closely related to the complex neuropathological abnormalities of PD [8]. The atrophy of the hippocampus and frontal cortex as well as the precipitation of abnormal proteins in PD patients may contribute to cognitive deficit. Traditional treatments such as physical exercises, pharmacotherapy, and cognitive therapy have some benefits for patients’ life. Some of these therapies may cause a series of side effects such as nausea, vomiting, and aggravating symptoms of exercise [11]. Identifying safe therapies to alleviate symptoms remains a priority
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