SynthesisBrain and behavior2026
Efficacy and Evidence Certainty of High-Frequency rTMS for Cognitive Impairment Across Neuropsychiatric Disorders: An Umbrella Review.
Synthesis in Brain and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
backgroundHigh-frequency repetitive transcranial magnetic stimulation (HF-rTMS) is a promising intervention for cognitive impairment across neuropsychiatric disorders. However, existing evidence remains fragmented within disease-specific reviews, lacking cross-disorder synthesis and rigorous evaluation of evidence certainty.
objectiveThis umbrella review systematically evaluates the efficacy of HF-rTMS on cognitive function across six neuropsychiatric disorders with sufficient meta-analytic evidence on cognitive outcomes, including Alzheimer's disease, vascular cognitive impairment, Parkinson's disease, schizophrenia spectrum disorders, major depressive disorder, and attention-deficit/hyperactivity disorder-and assesses the certainty of evidence.
methodsWe systematically searched CNKI, Cochrane Library, Embase, PubMed, and Web of Science from inception to March 1, 2026, for systematic reviews or meta-analyses reporting cognitive outcomes. Re-meta-analyses were performed using a random-effects model to calculate standardized mean differences (SMDs) with 95% confidence intervals (CIs). Study quality was appraised via AMSTAR-2, and evidence certainty was graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The corrected covered area (CCA) was calculated to quantify overlap of primary studies across reviews.
resultsTwenty-nine meta-analyses comprising 54 outcome indicators met the inclusion criteria. Pooled analysis indicated that HF-rTMS significantly improved global cognitive function (SMD = 0.68, 95% CI: 0.53-0.83, p < 0.001), though with substantial heterogeneity (I
conclusionHF-rTMS appears to provide consistent cognitive benefits in Alzheimer's disease and VCI, whereas its efficacy in other neuropsychiatric disorders remains uncertain. Given the low certainty of evidence and substantial heterogeneity, findings should be interpreted with caution. Future large-scale, multicenter randomized controlled trials with standardized protocols are needed to confirm efficacy and support clinical implementation.
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