Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 9/16/2025

Effects of Transcranial Magnetic Stimulation on Memory During Treatment

Mechanisms of Action and Effects on Cognition

  • The American Academy of Neurology notes that Transcranial Magnetic Stimulation (TMS) is a non-invasive technique that uses magnetic pulses to modify neural activity, which can be applied in two main forms: "online" (during a cognitive task) or "offline" (before the task) 1
  • During online TMS, stimulation applied at specific moments while individuals perform cognitive tasks can cause a "virtual lesion," temporarily interrupting ongoing cognitive processing 2
  • High-frequency TMS (≥10 Hz) has been shown to significantly interrupt accuracy in memory tasks compared to sham stimulation 3

Specific Effects on Memory

  • TMS applied at 10 Hz significantly impaired performance in language, memory, motor, and perception tasks 3
  • Stimulation at 20 Hz significantly interrupted accuracy in tasks involving attention, executive functions, memory, and perception 3
  • The neuromodulatory effects of TMS strongly depend on stimulation conditions, including spatial parameters (coil geometry, stimulation target) and temporal parameters (frequency, number of pulses) 4

Factors Influencing Cognitive Effects

  • The targeting approach is a significant factor that predicts TMS effects on cognition 5
  • The interval between pulse trains (ITI) also influences behavioral outcomes, with shorter intervals tending to interrupt accuracy in tasks 6
  • Stimulation frequency is a crucial parameter, with different frequencies distinctly affecting cognitive domains 3

Clinical Considerations

  • TMS online can cause failures in visual stimulus identification when applied at specific moments after stimulus presentation 2

Recommendations to Minimize Effects on Memory

  • Using lower frequencies (≤5 Hz) when the goal is not to interrupt cognitive processes, as higher frequencies (10-20 Hz) have a higher probability of causing temporary forgetting 3
  • Considering longer intervals between pulse trains to minimize interruption of accuracy in cognitive tasks 6
  • Personalizing stimulation parameters based on individual cortical anatomy can help normalize TMS dosage and potentially reduce adverse cognitive effects 6

REFERENCES

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