Effect of rTMS on Parkinson’s cognitive function: a systematic review and meta-analysis

Jiang, Yiguo; McClure, Morgan A.; He, Lin; Mu, Qiwen

doi:10.1186/s12883-020-01953-4

Cited by 35 publications

(33 citation statements)

References 70 publications

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“…A greater number of treatment sessions is associated with better SE and sleep quality as measured by PSQI, and a greater number of pulses per session is associated with an improved PSQI. These findings are consistent with many previous studies among people with other mental disorders (93)(94)(95)(96)(97). Meanwhile, the inverse associations between the length of treatment per session and TST and PSQI are also noteworthy.…”

Section: Discussionsupporting

confidence: 92%

Effectiveness of TES and rTMS for the Treatment of Insomnia: Meta-Analysis and Meta-Regression of Randomized Sham-Controlled Trials

Lin

et al. 2021

Front. Psychiatry

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Objectives: Transcranial electric stimulation (TES) and repetitive transcranial magnetic stimulation (rTMS) have experienced significant development in treating insomnia. This review aims to examine the effectiveness of randomized sham-controlled trials of TES and rTMS in improving insomnia and examine potential moderators associated with the effect of the treatment.Methods: Nine electronic databases were searched for studies comparing the effects of TES/rTMS with sham group on insomnia from the inception of these databases to June 25, 2021, namely, Medline, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science, PubMed, ProQuest Dissertation and Thesis, and CNKI. Meta-analyses were conducted to examine the effect of TES and rTMS in treating insomnia. Univariate meta-regression was performed to explore potential treatment moderators that may influence the pooled results. Risk of bias was assessed by using the Cochrane Risk of Bias Tool.Results: A total of 16 TES studies and 27 rTMS studies were included in this review. The pooled results indicated that there was no significant difference between the TES group and the sham group in improving objective measures of sleep. rTMS was superior to its sham group in improving sleep efficiency, total sleep time, sleep onset latency, wake up after sleep onset, and number of awakenings (all p < 0.05). Both TES and rTMS were superior to their sham counterparts in improving sleep quality as measured by the Pittsburgh Sleep Quality Index at post-intervention. The weighted mean difference for TES and rTMS were −1.17 (95% CI: −1.98, −0.36) and −4.08 (95% CI: −4.86, −3.30), respectively. Gender, total treatment sessions, number of pulses per session, and length of treatment per session were associated with rTMS efficacy. No significant relationship was observed between TES efficacy and the stimulation parameters.Conclusions: It seems that TES and rTMS have a chance to play a decisive role in the therapy of insomnia. Possible dose-dependent and gender difference effects of rTMS are suggested.

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Section: Discussionsupporting

confidence: 92%

Effectiveness of TES and rTMS for the Treatment of Insomnia: Meta-Analysis and Meta-Regression of Randomized Sham-Controlled Trials

Lin

et al. 2021

Front. Psychiatry

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“…This is very encouraging, given that AD and dementias share several common elements with these disorders, such as their pathogenetic mechanisms [77,78]. Additionally, these diseases are known for their cognitive sequelae [79,80], and rTMS has been explored as a treatment modality for cognitive decline in this context as well [5,72]. As such, rTMS's efficacy in this setting raises hopes for its application in dementia as well.…”

Section: Discussionmentioning

confidence: 91%

“…RTMS has been extensively studied in the context of PD, and a recent meta-analysis on the effects of rTMS on the cognitive performance of PD patients reported that HF-rTMS over the DLPFC may indeed be beneficial [72]. Due to the similarities between LBD and PD, and the existing literature and evidence on rTMS's efficacy on psychiatric disorders [73], it has long been hypothesized that rTMS could also be a therapeutic option for LBD [71].…”

Section: Lewy Body Dementiamentioning

confidence: 99%

Repetitive Transcranial Magnetic Stimulation in the Treatment of Alzheimer’s Disease and Other Dementias

et al. 2021

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Dementia is a debilitating impairment of cognitive functions that affects millions of people worldwide. There are several diseases belonging to the dementia spectrum, most prominently Alzheimer’s disease (AD), vascular dementia (VD), Lewy body dementia (LBD) and frontotemporal dementia (FTD). Repetitive transcranial magnetic stimulation (rTMS) is a safe, non-invasive form of brain stimulation that utilizes a magnetic coil to generate an electrical field and induce numerous changes in the brain. It is considered efficacious for the treatment of various neuropsychiatric disorders. In this paper, we review the available studies involving rTMS in the treatment of these dementia types. The majority of studies have involved AD and shown beneficial effects, either as a standalone, or as an add-on to standard-of-care pharmacological treatment and cognitive training. The dorsolateral prefrontal cortex seems to hold a central position in the applied protocols, but several parameters still need to be defined. In addition, rTMS has shown potential in mild cognitive impairment as well. Regarding the remaining dementias, research is still at preliminary phases, and large, randomized studies are currently lacking.

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“…Recent evidence suggests the efficacy of rTMS in improving response inhibition in Parkinson’s disease when applied over the dorsolateral prefrontal cortex 100 . Yet, to our best knowledge, no studies have targeted the pre-SMA with aim modifying cognitive control in Parkinson’s disease with or without ICDs.…”

Section: Discussionmentioning

confidence: 99%

A circuit-based approach to repair hypersexuality in Parkinson’s disease

Mata-Marín

Pineda-Pardo

Michiels

et al. 2022

Preprint

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One common neuropsychiatric complication in patients with Parkinson's disease treated with dopamine replacement therapy is impulse control disorders. A proportion of patients under dopamine agonist exhibit excessive desire towards appetitive cues accompanied by lost control over behaviour in forms of pathological gambling, hypersexuality or binge eating. The balance between enhanced desire towards sexual cues and cognitive control changes has been hypothesized to be biased toward the former in individuals with hypersexuality and impulse control disorders. Yet, some studies report no behavioural differences in cognitive control differences between impulsive patients and general Parkinson's disease, suggesting possible functional changes along the mesocorticolimbic cortico-subcortical circuitry. Here, we provide evidence for this hypothesis by comparing the neurobiological substrate of sexual disturbance over response inhibition associated to medication states in Parkinson's disease patients with a specific subtype of impulse control disorders (i.e., hypersexuality). We assessed the impact of sexual cues on response inhibition using a novel erotic stop signal task inside an fMRI. A total of 50 participants were included divided in 16 hypersexual and 17 non-hypersexual Parkinson's disease patients and 17 healthy controls. Task-related activations, functional and anatomical connectivity models were performed. Additionally, a separate sample of 20 hypersexual Parkinson's disease patients received excitatory neuromodulation (sham-controlled) over the pre-supplementary motor area (based on fMRI group-based results) aiming to improve response inhibition when exposed to sexual cues. Compared with their non-hypersexual peers, medication perturbed response inhibition upon presentation of sexual cues in patients with hypersexuality, recruiting a network involving caudate, pre-supplementary motor area, ventral tegmental area, and anterior cingulate cortex. Dynamic causal modelling revealed distinct best models to account for cortico-subcortical interactions with reduced task-related inputs in pre-supplementary motor area and descending connectivity to caudate in hypersexual compared to non-hypersexual Parkinson's disease patients (while medicated). This was sustained by enhanced fractional anisotropy and reduced mean diffusivity in the pre-supplementary motor area-caudate pathway. Importantly, stimulation over the pre-supplementary motor area improved response inhibition when exposed to sexual cues in hypersexual Parkinson's disease. We identified a specific fronto-striatal and mesolimbic circuitry underlying uncontrolled sexual behaviours in Parkinson's disease induced by medication, with recovery options by applying neuromodulation.

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Effect of rTMS on Parkinson’s cognitive function: a systematic review and meta-analysis

Cited by 35 publications

References 70 publications

Effectiveness of TES and rTMS for the Treatment of Insomnia: Meta-Analysis and Meta-Regression of Randomized Sham-Controlled Trials

Effectiveness of TES and rTMS for the Treatment of Insomnia: Meta-Analysis and Meta-Regression of Randomized Sham-Controlled Trials

Repetitive Transcranial Magnetic Stimulation in the Treatment of Alzheimer’s Disease and Other Dementias

A circuit-based approach to repair hypersexuality in Parkinson’s disease

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