ObjectiveAlzheimer’s disease (AD) is a prevalent neurodegenerative condition that significantly impacts both individuals and society. This study aims to evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) as a treatment for AD by summarizing the evidence from systematic reviews (SRs) and meta-analyses (MAs).MethodsSRs/MAs of rTMS for AD were collected by searching Embase, Web of Science, Cochrane Library, PubMed, CNKI, VIP, Sino-Med, and Wanfang databases. The search was conducted from database creation to January 23, 2024. Methodological quality, reporting quality and risk of bias were assessed using the Assessing Methodological Quality of Systematic Reviews 2 (AMSTAR-2), Risk of Bias in Systematic Reviews (ROBIS) tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). In addition, the quality of evidence for outcome measures was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).ResultsEight SRs/MAs included in this study met the inclusion criteria. Based on the AMSTAR-2, 4 of the SRs/MA were classified as low quality, while the remaining 4 were deemed to be of very low quality. The PRISMA analysis revealed that out of the 27 items reporting, 16 achieved full reporting (100%). However, there were still some deficiencies in reporting, particularly related to protocol and registration, search strategy, risk of bias, and additional analysis. The ROBIS tool indicated that only 3 SRs/MAs had a low risk of bias. The GRADE assessment indicated that 6 outcomes were of moderate quality (18.75%), 16 were of low quality (50%), and 10 were classified as very low quality (31.25%).ConclusionBased on the evidence collected, rTMS appears to be effective in improving cognitive function in AD patients, although the methodological quality of the SRs/MAs reduces the reliability of the conclusions and the overall quality is low. However, based on the available results, we still support the value of rTMS as an intervention to improve cognitive function in AD. In future studies, it is necessary to confirm the efficacy of rTMS in AD patients and provide more reliable and scientific data to contribute to evidence-based medicine.

中文翻译：

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重复经颅磁刺激治疗阿尔茨海默病：系统评价和荟萃分析概述

目的阿尔茨海默氏病 (AD) 是一种常见的神经退行性疾病，对个人和社会都有重大影响。本研究旨在通过总结系统评价（SR）和荟萃分析（MA）的证据来评估重复经颅磁刺激（rTMS）治疗AD的有效性。方法通过搜索Embase收集rTMS治疗AD的SRs/MAs 、Web of Science、Cochrane Library、PubMed、CNKI、VIP、Sino-Med 和万方数据库。检索从数据库创建到 2024 年 1 月 23 日进行。使用评估系统评价方法学质量 2 (AMSTAR-2)、系统评价偏倚风险 (ROBIS) 工具和系统评价和荟萃分析的首选报告项目 (PRISMA)。此外，还使用建议、评估、制定和评估分级 (GRADE) 来评估结果测量的证据质量。结果 本研究中纳入的 8 个 SR/MA 符合纳入标准。根据 AMSTAR-2，其中 4 个 SR/MA 被归类为低质量，而其余 4 个被认为质量非常低。 PRISMA 分析显示，在 27 个报告项目中，有 16 个项目实现了完整报告（100%）。然而，报告中仍然存在一些缺陷，特别是在方案和注册、检索策略、偏倚风险和额外分析方面。 ROBIS 工具表明，只有 3 个 SR/MA 的偏倚风险较低。 GRADE 评估表明，6 个结果为中等质量（18.75%），16 个结果为低质量（50%），10 个结果被分类为极低质量（31.25%）。结论根据收集的证据，rTMS 似乎是有效的尽管 SR/MA 的方法学质量降低了结论的可靠性且总体质量较低，但在改善 AD 患者的认知功能方面具有重要作用。然而，根据现有结果，我们仍然支持 rTMS 作为改善 AD 认知功能干预措施的价值。在未来的研究中，有必要证实rTMS对AD患者的疗效，并提供更可靠、科学的数据，为循证医学做出贡献。