Impact of repetitive transcranial magnetic stimulation on cortical activity: a systematic review and meta-analysis utilizing functional near-infrared spectroscopy evaluation.

The review included only healthy adults, so it does not show what rTMS does in patients receiving rehabilitation. Most included studies were small observational experiments, and only one study used a double-blind randomized controlled design. The rTMS protocols varied widely, including different frequencies, intensities, durations, and stimulation patterns, so the analysis could not cleanly separate protocol effects. fNIRS measurements varied in probe placement, number of channels, and optode distance, which makes comparisons across studies difficult. The meta-analysis had high heterogeneity, meaning the studies did not agree with one another. Scalp muscle twitching and movement artifacts could affect fNIRS readings, and many studies did not use methods to remove these effects. The paper reports trends and individual study patterns, but it does not provide clinical outcome evidence for motor recovery.

Funding was provided by National Taiwan University Hospital. The supplied text does not list other conflicts of interest.

Do not conclude that rTMS reliably changes brain oxygen levels in patients. The pooled analysis found no significant difference, the included studies were small and highly heterogeneous, and all participants were healthy adults.