Transcranial magnetic stimulation does not improve mild cognitive impairment in Parkinson's disease

Buard, Isabelle; Sciacca, David M.; Martin, Christine; Rogers, Sarah E; Sillau, Stefan; Greher, Michael R.; Chen, Robert; Kluger, Benzi M.

doi:10.1002/mds.27246

Cited by 22 publications

(18 citation statements)

References 6 publications

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“…The computer retrieved 208 articles. After reading the title and abstract and excluding duplicate documents, 14 documents were finally left that met the inclusion criteria [18,27,28,[30][31][32][33][34][35][36][37][38][39][40]. The detailed article screening process was shown in Fig.…”

Section: Characteristics Of the Included Research Literaturementioning

confidence: 99%

“…Although quantitative analysis was performed in these two studies, there is no further subgroup analysis for different rTMS parameters. Subsequently, in 2018, both Cohen et al [27] and Buard et al [28] published related studies. Therefore, the efficacy of rTMS on cognitive function of PD remains controversial and the optimal parameters are still unclear.…”

Section: Introductionmentioning

confidence: 99%

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

Jiang

McClure

et al. 2020

BMC Neurol

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Background 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. Method The 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. Results Fourteen 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. Conclusions Multiple 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.

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Section: Characteristics Of the Included Research Literaturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Jiang

McClure

et al. 2020

BMC Neurol

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“…Although quantitative analysis based on objective data is carried out in the above two articles, there is no further subgroup analysis for treatment parameters. Subsequently, in 2018, Cohen et al [27] and Buard et al [28] both published studies about the effects of rTMS treatment on cognitive function of PD patients. Therefore, the purpose of this study was to provide an objective and comprehensive analysis that whether rTMS treatment was effective on cognitive function of PD patients which cognitive domain obtained more from rTMS stimulation and which rTMS parameters are the most appropriate.…”

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confidence: 99%

Effect of rTMS on Parkinson's Cognitive Function: A Systematic Review and Meta-analysis

Jiang

McClure

et al. 2020

Preprint

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Background: To evaluate the effects and optimal parameters of repetitive transcranial magnetic stimulation (rTMS) on cognition function of Parkinson's disease (PD) patients and to estimate which cognitive function may obtain more benefits from rTMS. Method: The articles dealing with rTMS on cognition of PD patients were retrieved from the databases until April 2019. Two researchers selected research papers, evaluated their quality, extracted data, and cross-checked them according to the inclusion and exclusion criteria. The standardized mean differences (SMDs) with 95 % confidence interval (CI) of cognitive outcome for different parameters, scales, and cognitive functions were estimated. Results: Fourteen studies involving 173 subjects were included in the study. 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 including memory, attention, and language ability did not obtain significant effects. Conclusions: Multiple sessions of high-requency 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.

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“…Recent work assessing the efficacy of TMS in Parkinson's disease with mild cognitive impairment (PD-MCI) has shown mixed results. In the first study, a 2-week course of bilateral repetitive TMS (rTMS) at 20 Hz, or sham stimulation, was directed over the dorsolateral prefrontal cortex (DLPFC) ( 14 ). Cognition was assessed on the same day as the last stimulation session.…”

Section: Introductionmentioning

confidence: 99%

Theta-Burst Stimulation for Cognitive Enhancement in Parkinson's Disease With Mild Cognitive Impairment: A Randomized, Double-Blind, Sham-Controlled Trial

et al. 2020

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Background: Mild cognitive impairment is a common non-motor symptom of Parkinson's disease (PD-MCI) and has minimal treatment options.Objective: In this double-blind, randomized, sham-controlled trial, we assessed the effect of repeated sessions of intermittent theta-burst stimulation over the left dorsolateral prefrontal cortex on cognition and brain connectivity in subjects with PD-MCI.Methods: Forty-one subjects were randomized to receive real (n = 21) or sham stimulation (n = 20). All subjects underwent neuropsychological assessments before, 1 day, and 1 month after stimulation. Subjects also underwent resting-state functional magnetic resonance imaging before and 48 h after stimulation. The primary outcome was the change in the cognitive domain (executive function, attention, memory, language, and visuospatial abilities) z-scores across time.Results: There was an insignificant effect on cognitive domain z-scores across time when comparing real with sham stimulation and correcting for multiple comparisons across cognitive domains (p > 0.05 Bonferroni correction). However, the real stimulation group demonstrated a trend toward improved executive functioning scores at the 1-month follow-up compared with sham (p < 0.05 uncorrected). After real stimulation, the connectivity of the stimulation site showed decreased connectivity to the left caudate head. There was no change in connectivity within or between the stimulation network (a network of cortical regions connected to the stimulation site) and the striatal network. However, higher baseline connectivity between the stimulation network and the striatal network was associated with improved executive function scores at 1 month.Conclusions: These results suggest that intermittent theta-burst stimulation over the dorsolateral prefrontal cortex in subjects with PD-MCI has minimal effect on cognition compared with sham, although there were trends toward improved executive function. This intervention may be more effective in subjects with higher baseline connectivity between the stimulation network and the striatal network. This trial supports further investigation focusing on executive function and incorporating connectivity-based targeting.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03243214.

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Transcranial magnetic stimulation does not improve mild cognitive impairment in Parkinson's disease

Cited by 22 publications

References 6 publications

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

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

Effect of rTMS on Parkinson's Cognitive Function: A Systematic Review and Meta-analysis

Theta-Burst Stimulation for Cognitive Enhancement in Parkinson's Disease With Mild Cognitive Impairment: A Randomized, Double-Blind, Sham-Controlled Trial

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