Efficacy of transcranial magnetic stimulation for mild cognitive impairment: a systematic review and meta-analysis of randomized controlled trials
Abstract
Background: Transcranial magnetic stimulation (TMS) has been explored as a non-invasive intervention for cognitive impairment in mild cognitive impairment (MCI), but evidence regarding its overall efficacy remains inconsistent. This meta-analysis evaluated the pooled effect of TMS on cognitive outcomes in patients with MCI.
Methods: Randomized controlled trials (RCTs) enrolling participants with MCI only were identified from PubMed, CENTRAL, and Embase through November 10, 2025, in accordance with PRISMA and a PROSPERO-registered protocol (CRD420251274531). Cognitive outcomes were pre-specified and synthesized by domain, including global cognition and executive function (primary focus), as well as memory, language/naming, and neuropsychiatric measures. Pooled effects were calculated using fixed- or random-effects models as appropriate and reported as mean differences (MD) or standardized mean differences (SMDs) calculated as Hedges'g with 95% confidence intervals. Risk of bias, methodological quality, and certainty of evidence were assessed using RoB 1, PEDro, and GRADE.
Results: Eleven RCTs (532 participants with MCI) were included. rTMS improved global cognition on MMSE (MD = 2.35, 95% CI 1.74-2.96; k = 5, n = 120) and MoCA (MD = 1.31, 95% CI 0.80-1.82; k = 6, n = 337). Verbal memory also improved in AVLT-based outcomes (delayed recall: k = 5, n = 125; recognition: k = 4, n = 103). Attention/executive measures favored rTMS, including Digit Span (MD = 0.62, 95% CI…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 532 participants or records.
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