Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training on Patients with Post Stroke Cognitive Impairment： A Meta-Analysis
Bibliographic record
Abstract
ObjectiveTo evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training on patients with post stroke cognitive impairment (PSCI) by Meta-analysis.MethodsData were searched and retrieved from the databases of PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Science and Technology Periodical Database (VIP). The randomized controlled trials (RCTs) of rTMS combined with cognitive training for the treatment of patients with PSCI were included, and the retrieval time was from database inception to June 2023. The primary outcome measures included Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), activities of daily living (ADL) scale and Rivermead behavioural memory test (RBMT). The quality of the literature was assessed by two investigators using the Cochrane risk of bias assessment tool, and Meta-analysis was performed using RevMan 5.3 software. Enumeration data were expressed as odds ratio (OR) or relative risk ratio (RR). Measurement data were expressed as mean difference (MD) or standardized mean difference (SMD), with 95% confidence interval (CI). The heterogeneity was determined according to the P value and I2 value. If P≥0.10 and I2≤50%, a fixed effects model would be used, and if P<0.10 and I2>50%, a random effects model would be used.ResultsA total of 23 RCTs with 1 788 patients were included, 895 patients in the control group and 893 patients in the experimental group. (1) MoCA scores: subgroup analyses by different treatments in the control group showed that MoCA scores in the experimental group were significantly higher than those in the control group [MD=1.78, 95% CI (1.18, 2.38), P<0.000 1; MD=3.30, 95% CI (3.01,3.58), P<0.000 01]; subgroup analyses by stimulation frequency showed that MoCA scores in the experimental group were significantly higher than those in the control group [MD=3.49, 95% CI (3.40, 3.57), P<0.000 01; MD=3.16, 95% CI (2.79, 3.53), P<0.000 01]. (2) MMSE score: compared with the control group, MMSE score in the experimental group was higher [MD=2.14, 95% CI (1.14, 3.15), P<0.000 1; MD=3.16, 95% CI (2.71, 3.60), P<0.000 01]. (3) ADL score: compared with the control group, ADL score in the experimental group was higher [MD=10.78, 95% CI (9.18, 12.38), P<0.000 01; MD=8.23, 95% CI (7.04, 9.41), P<0.000 01]. (4) RBMT score: compared with the control group, RBMT score in the experimental group was higher [MD=2.00, 95% CI (1.37, 2.63), P<0.000 01].ConclusionrTMS combined with cognitive training can improve cognitive function, intelligence state, behavioral memory ability and activities of daily living of stroke patients, which is recommended for clinical application.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.013 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.021 | 0.049 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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 source (direct Gemma or distilled Codex), 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".