Effects of high-frequency repetitive transcranial magnetic stimulation on memory of post-stroke cognitive impairment patients: A systematic review and meta-analysis

BackgroundThere is an evident interrelationship between stroke and Alzheimer's disease (AD). Post-stroke cognitive impairment (PSCI) is a frequently encountered and potentially disabling outcome of stroke. Memory impairment is an important component of the post-stroke cognitive syndrome, and high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) has been widely used for memory in patients with PSCI.ObjectiveIn this study, we systematically evaluated the therapeutic effects of HF-rTMS on memory function in patients with PSCI, offering insights that may also inform the treatment of AD.MethodsAll relevant publications in Chinese and English were systematically searched from ten databases up to March 20, 2025. Retrieved articles were carefully screened. The quality of the included studies was assessed using the Cochrane Collaboration's risk of bias tool. The Review Manager 5.4 software was adopted for meta-analysis.ResultsTwenty-one studies of 1746 participants with PSCI were included. Meta-analysis revealed that HF-rTMS ameliorated memory of PSCI patients according to several outcome indicators: Rivermead Behavioural Memory Test [mean difference (MD) = 2.59, 95% confidence interval (CI) (2.08, 3.11), p < 0.00001], forward digit span [MD = 1.79, 95% CI (1.36, 2.22), p < 0.00001] and backward digit span [MD = 1.18, 95% CI (0.77, 1.59), p < 0.00001] of digit span test, Delayed Recall of the Montreal Cognitive Assessment [MD = 0.53, 95% CI (0.47, 0.59), p < 0.00001]; all p < 0.05.ConclusionsThe HF-rTMS might enhance memory in patients with PSCI, with the left dorsolateral prefrontal cortex being the most common stimulation site.