Efficacy of high-frequency rTMS for cognitive impairment in multiple sclerosis: a comparative study of RRMS and SPMS

Abstract Background Multiple sclerosis (MS) can significantly impact cognitive function. Repetitive transcranial magnetic stimulation (rTMS) has shown promise in improving cognitive deficits in various neurological conditions. This study intended to examine the effectiveness of high-frequency rTMS in improving cognitive deficits in patients with relapsing–remitting MS (RRMS) and secondary progressive MS (SPMS). Results Before treatment, MOCA scores were significantly lower in the SPMS group (17.53 ± 1.13) as compared to the RRMS group (21.13 ± 1.25; p ≤ 0.05). After rTMS, both groups exhibited significant improvement in MOCA scores, with the RRMS group improving to 28.93 ± 0.96 and the SPMS group improving to 23.67 ± 1.11 (both p ≤ 0.01). However, the magnitude of improvement was more significant in the RRMS group, with a mean improvement of 7.80 ± 1.37 (39.23% ± 7.52%) as compared to 6.13 ± 1.41 (32.81% ± 6.85%) in the SPMS group ( p ≤ 0.01 for degree of improvement and p ≤ 0.01 for percentage improvement). Conclusion These findings suggest that high-frequency rTMS may be a beneficial therapeutic option for improving cognitive function in both RRMS and SPMS patients. However, the degree of cognitive enhancement may vary depending on the disease course.