Published September 24, 2026, in Frontiers in Aging Neuroscience, this systematic review and meta-analysis brought together 14 randomized trials contributing 15 datasets on repetitive transcranial magnetic stimulation, or rTMS, for mild cognitive impairment.
What the pooled evidence found The primary Montreal Cognitive Assessment analysis included 672 participants and favored active rTMS, with Hedges' g of 1.46. Results also favored active treatment on the Mini-Mental State Examination and Rivermead Behavioral Memory Test.
Why caution matters The MoCA estimate varied substantially across studies, with I2 of 86%. Only two trials were rated low risk of bias overall, while eight were high risk and four unclear. A statistical test also suggested small-study effects. The review could not establish an optimal target, frequency, dose or treatment schedule, and cognitive-test changes were not consistently tied to daily function or independence.
Safety reporting Ten datasets provided quantitative safety data. Reported adverse events did not differ significantly between active and sham groups, and the most common events were transient headache and dizziness. Five datasets lacked usable quantitative safety information, so long-term and rare risks remain incompletely characterized.
What this adds The direction of the randomized evidence is encouraging, but the pooled estimate should be read as an average across diverse protocols rather than a prediction for an individual patient. Better-blinded trials with standardized protocols, functional outcomes and longer follow-up are still needed.
Source and disclosure Full text checked. The review received Chinese national, Sichuan and Chengdu public research funding, and the authors declared no commercial or financial conflict. Prepared with AI assistance and source-checked September 27, 2026.