Open AccessRepetitive transcranial magnetic stimulation therapy for motor recovery in Parkinson's disease: A Meta‐analysis
Author(s) -
Yang Changxia,
Guo Zhiwei,
Peng Haitao,
Xing Guoqiang,
Chen Huaping,
McClure Morgan A.,
He Bin,
He Lin,
Du Fei,
Xiong Liangwen,
Mu Qiwen
Publication year - 2018
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.1132
Subject(s) - transcranial magnetic stimulation , meta analysis , motor cortex , medicine , primary motor cortex , motor function , parkinson's disease , physical medicine and rehabilitation , rating scale , stimulation , psychology , disease , developmental psychology
Therapeutic effects of repetitive transcranial magnetic stimulation ( rTMS ) on motor recovery of Parkinson's disease ( PD ) have been reported; however, the protocols of these studies varied greatly. The aim of this meta‐analysis was to evaluate the optimal rTMS parameters for motor recovery of PD. Methods Electronic databases were searched for studies investigating the therapeutic effects of rTMS on motor function in patients with PD . The section III of the Unified Parkinson's Disease Rating Scale ( UPDRS ) was extracted as the primary outcome, and the standardized mean difference ( SMD ) with 95% confidence interval ( CI ) was calculated. Results Twenty‐three studies with a total of 646 participants were included. The pooled estimates of rTMS revealed significant short‐term ( SMD , 0.37; p < 0.00001) and long‐term ( SMD , 0.39; p = 0.005) effects on motor function improvement of PD . Subgroup analysis observed that high‐frequency rTMS ( HF ‐ rTMS ) was significant in improving motor function ( SMD , 0.48; p < 0.00001), but low‐frequency rTMS ( LF ‐ rTMS ) was not. In particular, when HF ‐ rTMS targeted over the primary motor cortex (M1), in which the bilateral M1 revealed a larger effect size than unilateral M1. Compared to single‐session, multi‐session of HF ‐ rTMS over the M1 showed significant effect size. In addition, HF ‐ rTMS over the M1 with a total of 18,000–20,000 stimulation pulses yielded more significant effects ( SMD , 0.97; p = 0.01) than other dosages. Conclusions In conclusion, multi‐session of HF ‐ rTMS over the M1 (especially bilateral M1) with a total of 18,000–20,000 pulses appears to be the optimal parameters for motor improvement of PD .