Mild cognitive or neurocognitive impairment (MCI) may be more prevalent in rural areas. Differences between rural and urban MCI patients in terms of risk factors, course and prognosis are rarely reported. The present review aims to summarize the latest research on MCI in rural areas. A literature search was performed in the databases of PubMed, Scopus and ScienceDirect for articles published over the last decade. Eleven articles were included in this review, reporting on the differences between rural and urban MCI patients. Several risk factors, such as older age, lack of activities and food insecurity have been associated with MCI in both rural and urban areas, whereas others, such as obesity, adverse childhood experiences and plasma chemokine C-C motif ligand 11 (considered as a potential negative regulator of neurogenesis), differed according to the place of residence. No specific protective factor for rural women has been reported. There is some evidence that MCI may present earlier in rural residents, but that progression to dementia may be more rapid in urban residents. It seems that there may be clinically relevant differences in the onset, course and prognosis of MCI with regards to the place of residence (urban vs rural). Those differences should be taken into account for the design of health policies and service delivery across different settings.
Transcranial magnetic stimulation (TMS) is a non-invasive method of brain stimulation that is receiving increasingly attention for new clinical applications. Through electromagnetic induction cortical activity can be modulated and therapeutic effects can be achieved in a variety of psychiatric and neurological conditions. According to the World Health Organization (WHO) depression is the most disabling disease in the world and 350 million people suffer from depression globally. Major depression is the most common disorder to be treated with TMS and the first mental disorder for which TMS received approval from the US Food and Drug Administration (FDA). We here introduce the basic principles of TMS, discuss the latest data on safety and side effects, and present various TMS treatment protocols as well as treatment response predictors in major depressive disorder.
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