Repetitive transcranial magnetic stimulation for cognitive rehabilitation in stroke survivors: A systematic review and meta-analysis of randomized controlled trials
Bibliographic record
Abstract
Cognitive impairments are one of the most common consequences in stroke survivors. Repetitive transcranial magnetic stimulation (rTMS) produces electromagnetic pulses transmitted through a coil over the individual’s head. This review aims to examine the effects of rTMS on cognition in stroke survivors, identify who would be most likely to benefit from the therapy, define the optimal therapeutic parameters, and provide recommendations. “PubMed, Medline, Scopus, EMBASE, PEDro, and Web of Science” were searched until December 5, 2024. Comprehensive Meta-Analysis version 4 was used for quantitative analysis. The “Cochrane Collaboration tool” was employed to assess the quality of the selected studies. Thirteen studies met the eligibility criteria. In total, 608 stroke survivors (mean age 60.17 years) were involved in the present review. The meta-analysis showed a small, non-significant effect of rTMS on global cognitive function in stroke survivors (Functional independence measure-cognitive; SMD = 0.386, 95% CI: −0.331 to 1.103, p = .291), (Mini-Mental State Examination; SMD = 0.162, 95% CI: −0.405 to 0.730, p = .575), and (Montreal Cognitive Assessment; SMD = 0.204, 95% CI: −0.613 to 1.021, p = .625) with high heterogeneity (I2 = 77–85%). While some studies reported improvements in specific cognitive domains, overall findings indicate substantial variability and uncertainty. This review highlights inconclusive evidence on the effects of rTMS on various cognitive domains in patients with stroke. The frequency of rTMS and coil location are essential factors in determining outcomes. Future studies are strongly warranted.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.088 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.053 | 0.009 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".