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Research and Advances in Psychiatry

rTMS to improve cognitive function in Alzheimer’s disease

Review article, 63 - 70
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Background: There have been carefully optimistic reports on the ability of repetitive Transcranial Magnetic Stimulation (rTMS) to improve cognitive function in Alzheimer’s disease (AD). However due to inadequate data for analysis from randomized controlled trials (RCTs) uncertainties remain regarding dosing, potential additive effect with medication and duration of cognitive effects. Methods: A literature search was conducted to identify studies published between January 2015 and December 2018 on subjects with a diagnosis of AD without significant co-morbid psychiatric illness. Results: All of the 3 RCTs and 4 non- RCT studies identified utilised the Alzheimer’s Disease Assessment Scale- Cognitive subscale (Adas- Cog) in their outcome measures on cognition. Although only one RCT demonstrated a significant improvement in cognition compared to sham treatment, all studies reported improvement compared to baseline measures. A few contributes noted this benefit to be particularly evident in the earlier stages of AD. Discussion: Although a large proportion of the evidence reviewed is limited by methodological weaknesses overall the evidence lends its support to the use of rTMS combined with cognitive tasks in AD. Further work is needed to distinguish the characteristics of those patients who are likely to benefit.