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Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the cognition of patients with mild cognitive impairment (MCI).Methods:The PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, and VIP databases were searched for randomized controlled trials of rTMS treating MCI patients before March 2019. After screening the literature, extracting the data and two independent reviewers evaluating the quality of the included studies, the meta-analysis was conducted using version 5.3 of the RevMan software.Results:Nine studies covering 368 patients were included. The pooled results showed that compared with sham stimulation, rTMS treatment could effectively improve the cognitive ability (assessed using the Montreal instrument), episodic memory, verbal fluency and the amplitude of MCI patients′ P300 signals. P300 latency was also reduced. However, there was no significant difference, on average, in memory quotient or P300 latency between patients given rTMS plus donepezil hydrochloride and those given donepezil hydrochloride alone. Compared with the control groups, the rTMS treatment groups displayed slightly more frequent adverse reactions, mainly mild dizziness and scalp pain which disappeared within 1-2 hours without obvious residual effects.Conclusions:TMS treatment can effectively improve cognitive and memory function.
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Objective To investigate the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS)on esophageal cancer patients with depression and the influence on the brain micro-structure by using the DTI technology.Methods Ten esophageal cancer patients with depression (6 male,4 female)were enrolled in this study according to the inclusion criteria.All patients received 1 0 days of rTMS treatment (stimulation frequency:10 Hz;stimulation site left:dorsolateral prefrontal cortex (DLPFC);stimulation intensity:1 10 % rest motor threshold).Before the first time and after the last time of the rTMS treatment,the DTI image acquisition and the coefficient assessment of hamilton depression scale(HAMD),self-rating depression scale(SDS),and self-rating anxiety scale (SAS)were conducted.Comparison of the mean fractional anisotropy (FA)of the depression related brain regions between pre-and post-rTMS was performed.Pearson correlation coefficient was calculated between the changes of FA value and the depression scale changes as well to understand their relationship.Results The HAMD,SAS and SDS were significantly decreased after pos-t rTMS (t＝7.69, P＝0.000;t＝12.86,P＝0.000;t＝10.51,P＝0.000)compared with pre-rTMS.Also,after rTMS depression patients showed significantly increased FA value in the bilateral hippocampus,left pallidum,bilateral thalamus,left middle frontal cortex,bilateral anterior cingulate cortex, and bilateral superior temporal cortex.Significant negative correlation was observed between the FA changes of the left pallidum and SAS(r＝－0.646,P＝0.044),and between the FA changes of right thalamus and HAMD (r＝－0.712,P＝0.021).Conclusion High frequency rTMS over the left DLPFC has significant antidepressant effect on esophageal cancer patients with depression.This may be related to the modulation of rTMS on the micro-structure of the left pallidum and right thalamus.
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Objective To assess the effectiveness of repeated trans-cranial magnetic stimulation ( rTMS) in relieving post-stroke depression ( PSD). Methods PubMed, Embase, the Cochrane library, Web of Science, CNKI, WANFANG, and VIP were searched for reports of randomized, controlled trials of rTMS treatment of PSD published before June 2015. Crude standardized mean differences ( SMDs) and odds ratios with 95% confidence in-tervals ( CIs) were calculated for depression intensity and effectiveness rate after treatment using random or fixed effects models. Results Twenty-four studies involving 856 rTMS-treated patients and 802 control patients were in-cluded in the meta-analysis. The results showed that compared with the control group, PSD patients showed significant reductions in depression after rTMS treatment ( SMD=-1.36;95% CI-1.6 to-1.12;P≤0.05) . The total effective-ness rate in the treated group was 85% with a reduction in NIHSS score ( SMD=-0.82;95% CI-1.2 to-0.44;P≤0.05) . Subgroup analysis showed that neither the frequency of rTMS stimulation, the site stimulated, nor time after stroke had a significant influence on the effectiveness of rTMS. Additionally, a few studies reported adverse reactions after rTMS. Conclusion rTMS appears to be a safe and effective therapy for PSD. Further well-controlled trials may elucidate the mechanism underlying the placebo effects of the sham rTMS observed among PSD patients.