TY - JOUR
T1 - Repetitive transcranial magnetic stimulation may be superior to drug therapy in the treatment of Alzheimer's disease
T2 - A systematic review and Bayesian network meta-analysis
AU - Wei, Naili
AU - Liu, Haoxin
AU - Ye, Wenrui
AU - Xu, Shengliang
AU - Lu, Changhao
AU - Dai, Anxiang
AU - Hou, Ting
AU - Zeng, Xin
AU - Wu, Jie
AU - Chen, Jian
N1 - Funding Information:
This work was supported by grants from the National Nature Science Foundation (82001447), the Natural Science Foundation of Guangdong Province(2022A1515010687), special funds for Guangdong Special Funds for Science and Technology, (STKJ2021075 and STKJ2021077), Guangdong Basic and Applied Basic Research Foundation (22202104030000234), and 2020 Li Ka Shing Foundation Cross‐Disciplinary Research Grant (2020LKSFG11C). The study's design, data collection, analysis, interpretation, report writing, and the choice to submit the article for publication were all made independently of the funders.
Publisher Copyright:
© 2023 The Authors. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.
PY - 2023/10
Y1 - 2023/10
N2 - Background: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation therapy that is primarily used to treat a variety of neuropsychiatric conditions. Recently, previous research reports stated that rTMS have the characteristics of neurorestorative in Alzheimer's disease (AD). However, the relevant clinical research evidence has not been fully summarized. Methods: This article performed a network meta-analysis of individual participant data from eligible studies searched in PubMed, Embase, and the Cochrane Library from inception to March 31, 2022. The drug treatments involved were acetylcholinesterase inhibitors (AChEIs), N-methyl-d-aspartate (NMDA), anti-amyloid-beta (Aβ), and some new targeted therapeutic drugs. Results: A total of 15, 548 individuals with AD disease in 57 randomized clinical trials (RCTs) were included in this meta-analysis. The results indicated that the patients who received rTMS treatment (standard mean difference [SMD]: 0.65; 95% confidence interval [CI]: 0.22–1.07) had a better MMSE score than placebo. Treatment outcome analysis showed that, compared with multiple pharmacological interventions, rTMS acquired the greatest probability rank with the best cognitive improvement in MMSE score [the surface under the cumulative ranking curve (SUCRA) 93.3%] and ADAS-cog score (SUCRA 86.7%). At the same time, rTMS treatment had the lowest rank in the adverse events (SUCRA 24.1%) except for the placebo group (SUCRA 19.1%). Conclusion: Compared with the current clinical drug treatment, rTMS demonstrated better cognitive function improvement and fewer adverse events in AD patients. Therefore, rTMS shows broad prospects in the treatment of Alzheimer's disease, and it is worth being widely popularized in clinic.
AB - Background: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation therapy that is primarily used to treat a variety of neuropsychiatric conditions. Recently, previous research reports stated that rTMS have the characteristics of neurorestorative in Alzheimer's disease (AD). However, the relevant clinical research evidence has not been fully summarized. Methods: This article performed a network meta-analysis of individual participant data from eligible studies searched in PubMed, Embase, and the Cochrane Library from inception to March 31, 2022. The drug treatments involved were acetylcholinesterase inhibitors (AChEIs), N-methyl-d-aspartate (NMDA), anti-amyloid-beta (Aβ), and some new targeted therapeutic drugs. Results: A total of 15, 548 individuals with AD disease in 57 randomized clinical trials (RCTs) were included in this meta-analysis. The results indicated that the patients who received rTMS treatment (standard mean difference [SMD]: 0.65; 95% confidence interval [CI]: 0.22–1.07) had a better MMSE score than placebo. Treatment outcome analysis showed that, compared with multiple pharmacological interventions, rTMS acquired the greatest probability rank with the best cognitive improvement in MMSE score [the surface under the cumulative ranking curve (SUCRA) 93.3%] and ADAS-cog score (SUCRA 86.7%). At the same time, rTMS treatment had the lowest rank in the adverse events (SUCRA 24.1%) except for the placebo group (SUCRA 19.1%). Conclusion: Compared with the current clinical drug treatment, rTMS demonstrated better cognitive function improvement and fewer adverse events in AD patients. Therefore, rTMS shows broad prospects in the treatment of Alzheimer's disease, and it is worth being widely popularized in clinic.
KW - Alzheimer's disease
KW - Bayesian network meta-analysis
KW - cognitive function
KW - drug therapy
KW - repetitive transcranial magnetic stimulation
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U2 - 10.1111/cns.14228
DO - 10.1111/cns.14228
M3 - Article
C2 - 37088953
AN - SCOPUS:85153485267
SN - 1755-5930
VL - 29
SP - 2912
EP - 2924
JO - CNS Neuroscience and Therapeutics
JF - CNS Neuroscience and Therapeutics
IS - 10
ER -