Impulsivity is a multi-dimensional construct that is regarded as a symptom of many psychiatric disorders. Harm resulting from impulsive behaviour can be substantial for the individuals concerned, for their social network, and for wider society. Therefore, the importance of developing therapeutic interventions to target impulsivity is paramount. We conducted a systematic review and meta-analysis of the literature from AMED, Embase, Medline, and PsycINFO databases on the use of repetitive transcranial magnetic stimulation (rTMS) in healthy adults to modulate different subdomains (motor, temporal and reflection) of impulsivity. The results indicated that rTMS has distinct effects on different impulsivity subdomains. It has a significant, albeit small, effect on modulating motor impulsivity (g = 0.30, 95% CI, 0.17 to 0.43, p < .001) and a moderate effect on temporal impulsivity (g = 0.59, 95% CI, 0.32 to 0.86, p < .001). Subgroup analyses (e.g., excitatory vs. inhibitory rTMS, conventional rTMS vs. theta burst stimulation, analyses by stimulation sites, and type of outcome measure used) identified key parameters associated with the effects of rTMS on motor and temporal impulsivity. Age, sex, stimulation intensity and the number of pulses were not significant moderators for effects of rTMS on motor impulsivity. Due to lack of sufficient data to inform a meta-analysis, it has not been possible to assess the effects of rTMS on reflection impulsivity. The present findings provide preliminary evidence that rTMS can be used to modulate motor and temporal impulsivity in healthy individuals. Further studies are required to extend the use of rTMS to modulate impulsivity in those at most risk of engaging in harmful behaviour as a result of impulsivity, such as patients with offending histories and those with a history of self-harming behaviour.

中文翻译：

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rTMS对正常成年人冲动的影响：系统评价和荟萃分析

冲动性是多维结构，被认为是许多精神疾病的症状。冲动行为所造成的危害对于有关个人，其社交网络以及整个社会而言可能是巨大的。因此，开发针对目标冲动的治疗干预措施的重要性至关重要。我们对AMED，Embase，Medline和PsycINFO数据库中的文献进行了系统的回顾和荟萃分析，这些文献涉及在健康成年人中使用重复经颅磁刺激（rTMS）来调节冲动的不同子域（运动，时间和反射）。结果表明，rTMS对不同的冲动子域具有明显的影响。尽管对电机冲动的调节作用很小，但它具有显着的影响（g = 0.30，95％CI，0.17至0.43，p  <.001）和对时间冲动的中等影响（g  = 0.59，95％CI，0.32至0.86，p <.001）。亚组分析（例如，兴奋性与抑制性rTMS，常规rTMS与theta爆发刺激，按刺激部位进行的分析以及所使用的结果测量类型）确定了与rTMS对运动和时间冲动性影响相关的关键参数。年龄，性别，刺激强度和脉冲数不是rTMS对运动冲动性影响的重要调节剂。由于缺乏足够的数据来进行荟萃分析，因此无法评估rTMS对反射冲动的影响。本研究结果提供了初步的证据，证明rTMS可用于调节健康个体的运动和时间冲动。需要进一步的研究，以扩大使用rTMS来调节因冲动而极有可能从事有害行为的人的冲动性，