| Background:Repetitive transcranial magnetic stimulation(rTMS)has been approved for the treatment of depression and is increasingly used all over the world.Some studies suggest that the rTMS has enhanced effects on some cognitive functions compared with the sham group.However,some scholars have found no significant changes in the cognitive functions of patients with depression by comparing the two groups.Therefore,whether the rTMS treatment can enhance the cognitive functions of patients with depression is still a great controversy.Objective:To evaluate the cognitive enhancement effect of rTMS in patients with depression.Method: A randomized controlled study using computer retrieval of repetitive transcranial magnetic stimulation(rTMS)for the treatment of depressed patients and evaluation of cognitive function was conducted in domestic and international databases.The retrieved literatures were screened according to the predetermined inclusion criteria and exclusion criteria for systematic evaluation and meta analysis.Review manager 5.3.5 was used for statistical analysis.Results:1.A total of 25 studies met the inclusion criteria and then were finally included in this meta-analysis,including 10 English literatures and 15 Chinese literatures.A total of 1596 patients were involved in depression,among whom 819 received rTMS stimulation and 777 received sham stimulation in the control group.2.Processing speed:there were statistically significant differences in the SWCT-color test between rTMS group and the sham group(SMD:-0.31,95%CI :[-0.61,-0.01],p=0.04);and in the SWCT-word test the difference between the rTMS treatment group and the sham group also was statistically significant(SMD:-0.51,95%CI:[-0.89,-0.14],p=0.008).And,there was no statistically significant difference in the TMT-A between rTMS group and the sham stimulation group(SMD:-0.24,95%CI :[-0.50,0.02],p=0.05).There was no significant difference in the DSST between rTMS group and the sham group(SMD:0.20,95%CI :[-0.05,0.46],p=0.12).3.Attention:there was no statistically significant difference in the Digit span forwards between the rTMS group and the sham group(SMD:-0.09,95%CI :[-0.39,0.21],p=0.55).There was no statistically significant difference in the first part of CPT between the rTMS group and the sham group(SMD:0.32,95%CI :[-0.13,0.76],p=0.16),there was no statistically significant difference in the second part of CPT between the rTMS group and the sham group(SMD:0.11,95%CI :[-0.11,0.33],p=0.33),and there was also no statistically significant difference in the third part of CPT between rTMS group and the sham group(SMD:0.11,95%CI :[-0.11,0.33],p=0.31).4.Working memory:there was no statistically significant difference in the Digital span backwards between rTMS treatment group and the sham group(SMD:0.11,95%CI :[-0.27,0.50],p=0.56).5.Executive function:there was a statistically significant difference in the TMT-B between the rTMS group and the sham group(SMD:-0.60,95%CI :[-1.14,-0.05],p=0.03).There was no statistically significant difference in the WCST-total response between the rTMS group and the sham group(SMD:0.23,95%CI :[-0.02,0.48],p=0.07).There was no statistically significant difference in the SWCT color-word interference between the rTMS group and the sham group(SMD:0.04,95%CI :[-0.21,0.28],p=0.78).There was no significant difference in the WCST-preservative errors between the rTMS treatment group and the sham group(SMD:-0.33,95%ci :[-0.70,0.05],p=0.09).6.Verbal memory:there was no statistically significant difference in the RAVLT between the rTMS group and the sham group(SMD:0.13,95%CI :[-0.24,0.50],p=0.09).7.The global cognitive function:there was no statistically significant difference in MMSE between the rTMS group and the sham group(SMD:-0.53,95% CI :[-1.24,0.17],p=0.14).Conclusion: In terms of processing speed and executive function,rTMS treatment has a cognitive enhancement effect on patients with depression,so it can be considered that rTMS treatment is a beneficial intervention for people with depression. |
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