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A meta-analysis of hippocampal indirectly targeted stimulation (HITS) effects on episodic memory

Poster Session A - Saturday, March 7, 2026, 3:00 – 5:00 pm PST, Fairview/Kitsilano Ballrooms

Joel Voss¹ (joelvoss@uchicago.edu), Arantzazu San Agustin¹, Elena Badillo Goicoechea¹, Phillip Agres¹, Johanna Rau¹; ¹The University of Chicago

Episodic memory is critically dependent on the hippocampal network and is frequently impaired in many clinical disorders. Hippocampal Indirectly Targeted Stimulation (HITS) is a promising, noninvasive transcranial magnetic stimulation (TMS) intervention to enhance episodic memory performance. We present a comprehensive meta-analysis of HITS effects on episodic memory, encompassing 253 statistical comparisons (effects) from 38 published studies of N = 1,009 subjects, including healthy individuals and clinical populations. Meta-regression was used to assess the overall effect of HITS on episodic memory versus tests of other cognitive abilities, as well as to assess whether effects were modulated by study design factors such as the population assessed, the memory test format, and the stimulation parameters. HITS robustly improved episodic memory overall (P<0.001), with effects selective for episodic memory versus other non-memory cognitive domains. Efficacy was significantly greater when memory performance was assessed using memory tasks sensitive to recollection, which is strongly linked to hippocampal network function, compared to recognition or other types of episodic memory tasks (P=0.006). Efficacy was also significantly greater when HITS was delivered before versus after the period of memory encoding (P<0.001). No serious adverse events were reported. These findings establish HITS as a safe and effective approach for episodic memory enhancement, with potential for clinical translation in memory disorders. Selectivity of effects for episodic memory generally and for recollection-format tests in particular indicates cognitive and mechanistic specificity, supporting the potential for targeted and selective neuromodulation of hippocampal networks and their associated functions.

Topic Area: LONG-TERM MEMORY: Episodic