MS is a neurological disorder characterized by demyelination in the central nervous system, leading to increased muscle tone and motor dysfunction. TMS, a noninvasive technique, is used to stimulate nerve cells and activate specific regions of the brain. Multiple studies suggest TMS may improve motor symptoms, but the evidence quality is low and often insufficient to confirm its benefit.

Of the 919 studies screened, seven met the inclusion criteria, including 73 patients with a mean age of 45.7 years. In the evaluation of the Fatigue, being mainly made by the Modified Fatigue Impact Scale (MFIS), has found repetitive TMS as a valid choice to significantly reduce the mean ± SD for this outcome. (Variation post intervention: 3.95± 1.40 a 21.07 ± 10.06). Two measures were used to access balance and gait: the Timed Up and Go (TUG) and Berg Balance Scale (BBS). Across the included studies, the TMS group consistently showed significant improvements in both  TUG and BBS scores, indicating enhanced balance and gait capabilities. The Modified Ashworth Scale (MAS) was employed to evaluate spasticity. While a trend towards TMS, were a higher reduction has been seen in some studies, carried out by the comparison with a sham group.