PT  - JOURNAL ARTICLE
AU  - Xie, Haihua
AU  - Zhang, Ruhan
AU  - Cao, Sihui
AU  - Jiang, Jia
AU  - Huang, Bo
AU  - Liu, Mi
AU  - Peng, Liang
TI  - Repetitive transcranial magnetic stimulation in conjunction with scalp acupuncture in treating poststroke cognitive impairment: a protocol for systematic review and meta-analysis
AID  - 10.1136/bmjopen-2024-098535
DP  - 2025 May 01
TA  - BMJ Open
PG  - e098535
VI  - 15
IP  - 5
4099  - http://bmjopen.bmj.com/content/15/5/e098535.short
4100  - http://bmjopen.bmj.com/content/15/5/e098535.full
SO  - BMJ Open2025 May 01; 15
AB  - Introduction Approximately 70% of patients with stroke experience varying degrees of cognitive impairment, which imposes a substantial direct and indirect socioeconomic burden. Previous studies have shown that scalp acupuncture (SA) or repetitive transcranial magnetic stimulation (rTMS) in combination with other therapies is effective for poststroke cognitive impairment (PSCI). Limited by interstudy heterogeneity and the limited number of included studies, there is insufficient evidence of the efficacy of rTMS in combination with SA in treating PSCI. Therefore, this protocol aims to investigate the effectiveness of rTMS in conjunction with SA for patients with PSCI through a comprehensive meta-analysis.Methods and analysis This study will undertake a comprehensive search across nine distinct databases (Web of Science, Embase, Cochrane Library, PubMed, China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database, China Biology Medicine and SCOPUS). The primary outcome will encompass the Montreal Cognitive Assessment and the Mini-Mental State Examination. The secondary outcomes are the modified Barthel Index, the Rivermead Behavioral Memory Test and the Digit Span Test. The bias risk assessment tool from the Cochrane Handbook for Systematic Reviews of Interventions will be used to evaluate bias risk, and the GRADE will be applied to gauge the quality of evidence. Furthermore, we plan to perform an analysis of subgroups to investigate the heterogeneity, employ the leave-one-out approach for sensitivity evaluation and use funnel plots and Egger’s test to determine publication bias, respectively.Ethics and dissemination Ethical approval is not required in systematic review and meta-analysis. The review will be published in a peer-reviewed journal.PROSPERO registration number CRD42024571762.