***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background and Aim : Repetitive transcranial magnetic stimulation ( rTMS ) is supposed to be not as effective in severe depression as it is in medium depression . We evaluated the treatment response to an ultra-high-frequency ( UHF ; 30 Hz ) approach , which was used to maximize the rTMS efficacy in severely ill patients . Methods : 43 severely depressed patients were included in the r and omized , double-blind study and received either rTMS with 30 Hz over the left dorsolateral prefrontal cortex or sham condition for 3 weeks as an add-on therapy to stable antidepressant medication .  Hamilton Depression Rating Scale ( HDRS ) and cognitive performance were evaluated before and after the intervention . Results : In the active UHF group , the HRDS score was reduced by about 7.2 , whereas the sham condition showed a smaller reduction of the HDRS score with 3.9 . However , lithium as a covariant was responsible for the outcome difference , not the group of stimulation . No adverse events were reported . Comparing the differences of both groups in the pre- and post- study performance in a trail-making test , a group effect for the UHF group that was not influenced by the lithium intake was observed . Conclusion : A 30-Hz left prefrontal rTMS in severely depressed patients was safe and no adverse events occurred . Due to a strong effect of lithium as a covariate , we could not demonstrate favorable antidepressant effects of the UHF stimulation compared to sham . However , we found an improvement of processing speed performance in the UHF group , which covaried with improvement of psychomotor retardation Repetitive transcranial magnetic stimulation ( rTMS ) acts as a kind of widely-applied and non-invasive method in the intervention of some neurological disorders . This prospect i ve , r and omized , double-blind , placebo-controlled trial investigates the effect of rTMS on 30 cases of Alzheimer ’s disease ( AD ) participants , who were classified into mild and moderate groups .  Neuropsychological tests were carried out using the AD Assessment Scale-cognitive subscale ( ADAS-cog ) , Mini-Mental State Examination ( MMSE ) , Montreal Cognitive Assessment ( MoCA ) , and World Health Organization University of California-Los Angeles , Auditory Verbal Learning Test ( WHO-UCLA AVLT ) before , immediately after , and 6 weeks after the intervention . In this work , data from 30 AD patients revealed that there was no obvious interaction effect of time-by-group . The ADAS-cog , MMSE and WHO-UCLA AVLT score in the rTMS group was significantly improved compared with baselines at 6 weeks after treatment ( all p<0.05 ) . Meanwhile , MoCA scores were also obviously ameliorated in the mild AD patients with rTMS . Besides , subgroup analysis showed that the effect of rTMS on the memory and language of mild AD patients was superior to those of moderate AD patients . In conclusion , our findings suggested that repetitive transcranial magnetic stimulation improves cognitive function , memory and language level of AD patients , especially in the mild stage of AD . Thus , rTMS can be recommended as a promising adjuvant therapy combined with cholinesterase inhibitors at the mild stage of AD patients Background and Objective : We previously reported a r and omized , sham-controlled trial of 5 Hz dorsolateral prefrontal left- and right-side repetitive transcranial magnetic stimulation ( rTMS ) in 48 participants with a medically refractory major depressive disorder . Depression improved most with right-side cranial stimulation , both rTMS and sham , and to a lesser degree with left rTMS . Because depression is often associated with cognitive impairment , in this study we sought to determine whether our earlier participants had treatment-induced changes in cognition , which cognitive domains ( language , executive , visuospatial , verbal episodic memory , attention ) were affected , and whether treatment-induced cognitive changes were related either to improvement in depression or to other treatment variables , such as right versus left treatment and rTMS versus sham . Methods : We used hierarchical regression analyses to determine how variables measured at baseline or associated with treatment affected changes in neuropsychological functions . The variables were neuropsychological function in the 5 domains , severity of depression , change in depression with treatment , rTMS versus sham , laterality of stimulation , and  rTMS-laterality interaction . Results : Compared to sham , right rTMS was associated with 1.24 st and ard deviations greater gain in language function , 1.09 st and ard deviations greater gain in visuospatial function , and 2.38 st and ard deviations greater gain in verbal episodic memory than left rTMS . These improvements did not appear to be directly related to the relief from depression . Conclusions : Our results suggest that disorders of cognition and mood in depression may have different mechanisms , but right rTMS may treat both . We propose potential mechanisms underlying the right-side rTMS effect . Clinical Trial Registration : Clinical trials.gov NCT00711568 BACKGROUND Even during symptomatic remission , many patients with medication resistant depression ( MRD ) still demonstrate impaired cognitive function , especially executive function ( EF ) . Theta-burst transcranial magnetic stimulation ( TBS ) modulates cortical excitability and may treat MRD . Evidence s from previous studies show that intermittent TBS ( iTBS ) produces cortical excitatory effects , while continuous TBS ( cTBS ) produces a reduction of cortical excitability . EF is highly dependent on prefrontal activity , but the effects of different forms of prefrontal TBS on EF remain unknown . METHODS 60 MRD patients were recruited and r and omly assigned to one of four groups . Treatment was determined by the group to which an individual was assigned ; A : cTBS 1800pulses/session ; B : iTBS 1800pulses/session ; C : a combination of cTBS+iTBS , 1800pulses/session for each ; and D : sham TBS .  Wisconsin Card Sorting Test ( WCST ) for the performance of EF was evaluated before and after 10 daily treatment sessions RESULTS Repeated measures ANOVA , with each WCST index at baseline and 2weeks after TBS as within-subject factors , demonstrated that a statistically significant interaction of TBS groups ( G ) and antidepressant responses [ ( R ) , responses were defined as > 50 % reduction of depression scores after 2-weeks TBS treatment ] on the before-versus-after changes of all WCST indexes ( G × R , p<0.05 ) . Responders in Group B , but not in the other groups , showed a significant improvement in WCST performance . Only nonresponders in Group A showed a trend for EF worsening . CONCLUSIONS Our findings showed that left prefrontal iTBS , not right prefrontal cTBS , improved EF , and this can be independent from its antidepressant effects Cortical excitability can be modulated using repetitive transcranial magnetic stimulation ( rTMS ) . Previously , we showed that rTMS combined with cognitive training ( rTMS-COG ) has positive results in Alzheimer ’s disease ( AD ) . The goal of this r and omized double-blind , controlled study was to examine the safety and efficacy of rTMS-COG in AD . Fifteen AD patients received 1-h daily rTMS-COG or sham treatment ( seven treated , eight placebo ) , five sessions/week for 6 weeks , followed by biweekly sessions for 3 months . The primary outcome was improvement of the cognitive score . The secondary outcome included improvement in the Clinical Global Impression of Change ( CGIC ) and Neuropsychiatric Inventory ( NPI ) . There was an improvement in the average ADAS-cog score of 3.76 points after 6 weeks in the treatment group compared to 0.47 in the placebo group and 3.52 points after 4.5 months of treatment , compared to worsening of 0.38 in the placebo ( P = 0.04 and P = 0.05 , respectively ) . There was also an improvement in the average CGIC score of 3.57 ( after 6 weeks ) and 3.67 points ( after 4.5 months ) , compared to 4.25 and 4.29 in the placebo group ( mild worsening ) ( P = 0.05 and P = 0.05 , respectively ) . NPI improved non-significantly . In summary , the NeuroAD system offers a novel , safe and effective therapy for improving cognitive function in AD To date , while the contribution of the striatum in executive processes is well documented , the role played by striatal dopamine during tasks requiring executive functions is still unknown . We used D2-dopamine receptor lig and [ (11)C ] raclopride PET in healthy subjects while performing the Montreal Card Sorting Task ( MCST ) .  We observed a striatal reduction in [ (11)C ] raclopride binding potential during planning of a set-shift when compared with matching according to an ongoing rule . These findings suggest that striatal dopamine neurotransmission increases significantly during the performance of specific executive processes confirming previous evidence of striatal activation during fMRI studies . The present observation may provide some insights on the origin of cognitive deficits underlying certain neurological disorders associated with dopamine dysfunction , such as Parkinson 's disease BACKGROUND Few studies have investigated the efficacy of repetitive transcranial magnetic stimulation ( rTMS ) treatment for negative symptoms of schizophrenia , reporting inconsistent results . We aim ed to investigate whether 10 Hz stimulation of the bilateral dorsolateral prefrontal cortex during 3 weeks enhances treatment effects . METHOD A multicenter double-blind r and omized controlled trial was performed in 32 patients with schizophrenia or schizo-affective disorder , and moderate to severe negative symptoms [ Positive and Negative Syndrome Scale ( PANSS ) negative subscale ⩾15 ] . Patients were r and omized to a 3-week course of active or sham rTMS . Primary outcome was severity of negative symptoms as measured with the Scale for the Assessment of Negative Symptoms ( SANS ) and the PANSS negative symptom score . Secondary outcome measures included cognition , insight , quality of life and mood . Subjects were followed up at 4 weeks and at 3 months . For analysis of the data a mixed-effects linear model was used . RESULTS A significant improvement of the SANS in the active group compared with sham up to 3 months follow-up ( p = 0.03 ) was found . The PANSS negative symptom scores did not show a significant change ( p = 0.19 ) . Of the cognitive tests , only one showed a significant improvement  after rTMS as compared with sham . Finally , a significant change of insight was found with better scores in the treatment group . CONCLUSIONS Bilateral 10 Hz prefrontal rTMS  reduced negative symptoms , as measured with the SANS . More studies are needed to investigate optimal parameters for rTMS , the cognitive effects and the neural basis BACKGROUND Electroconvulsive therapy ( ECT ) is an effective alternative for pharmacotherapy in treatment-resistant depressive patients , but the side effects limit its use . Transcranial magnetic stimulation ( TMS ) has been proposed as a refined alternative , but most studies do not indicate that TMS is as effective as ECT for severe depression . OBJECTIVE We propose that the limited effectiveness of st and ard TMS resides in its superficial effect on the cortex , although much of the pathophysiology of depression is associated with deeper and larger brain regions implicated in the reward system . Herein , we tested the effectiveness and safety of a novel TMS coil , the " H-coil , " which enables direct stimulation of deeper brain regions , at the expense of focality . METHODS We have studied the antidepressant and cognitive effects induced by 4 weeks of high-frequency ( 20 Hz ) repeated deep TMS ( DTMS ) over the prefrontal cortex ( PFC ) of 65 medication-free depressive patients , who have failed to benefit from prior medications . Patients were r and omly assigned to various treatment configurations , differing in stimulation intensity and laterality . Effects were assessed by the 24-item Hamilton depression rating scale ( HDRS-24 ) and several secondary outcome measures . RESULTS A significant improvement in HDRS scores was found when high , but not low , stimulation intensity was used . Several cognitive improvements were evident , and no treatment-related serious adverse events were observed . CONCLUSIONS DTMS over the PFC was found safe and effective in alleviating depression . The results accentuate the significance of deep , high-intensity stimulation over low , and serve as the first study to indicate the potential of DTMS in psychiatric and neurologic disorders Transcranial magnetic stimulation ( TMS ) is a noninvasive brain stimulation technique with potential to improve memory .  Mild cognitive impairment ( MCI ) , which still lacks a specific therapy , is a clinical syndrome associated with increased risk of dementia . This study aims to assess the effects of high-frequency repetitive TMS ( HF rTMS ) on everyday memory of the elderly with MCI . We conducted a double-blinded r and omized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex ( DLPFC ) . Thirty-four elderly out patients meeting Petersen 's MCI criteria were r and omly assigned to receive 10 sessions of either active TMS or sham , 10 Hz rTMS at 110 % of motor threshold , 2,000 pulses per session . Neuropsychological assessment at baseline , after the last session ( 10th ) and at one-month follow-up , was applied . ANOVA on the primary efficacy measure , the Rivermead Behavioural Memory Test , revealed a significant group-by-time interaction ( p = 0.05 ) , favoring the active group . The improvement was kept after one month . Other neuropsychological tests were  heterogeneous . rTMS at 10 
    Output:
    
Although the heterogeneity between studies in terms of cognitive measures applied , stimulation parameters , and participants limits the ability to generalize conclusions , this review demonstrated that prefrontal rTMS could exert pro‐cognitive effects on executive function and attention in some patients with depression but inconsistent cognitive impacts in any of the examined domains especially in patients with schizophrenia and Alzheimer 's disease .