Kang Nyeonju, Cauraugh James H
Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States of America.
Motor Behavior Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States of America.
PLoS One. 2017 Sep 28;12(9):e0185462. doi: 10.1371/journal.pone.0185462. eCollection 2017.
Essential tremor (ET) is the most common age-related disease leading to abnormal tremulous behaviors in the upper and lower extremities. Non-invasive brain stimulation (NIBS) may be an effective ET therapy by modulating the oscillating network of the brain. The current systematic review and meta-analysis examined the effects of NIBS interventions on tremor symptoms in ET patients. Our comprehensive search identified eight studies that used 1 Hz of rTMS, cTBS, or ctDCS protocols. Twenty total comparisons from the eight qualified studies were statistically synthesized, and the meta-analytic findings revealed that NIBS techniques reduced tremulous behaviors in individuals with ET. Moreover, the four moderator variable analyses demonstrated that the positive therapeutic effects of NIBS appeared across the following subgroups: (a) tremor assessment (clinical test vs. quantitative tremor assessment), (b) stimulation site (cerebellum vs. motor cortex), (c) session number (single session vs. multiple sessions), and (d) sustained positive treatment effect (posttest vs. retention test). This comprehensive systematic review and meta-analysis provided evidence that support positive treatment effects of NIBS techniques on ET motor therapy.
特发性震颤（ET）是最常见的与年龄相关的疾病，可导致上下肢出现异常震颤行为。非侵入性脑刺激（NIBS）通过调节大脑的振荡网络可能是一种有效的ET治疗方法。当前的系统评价和荟萃分析研究了NIBS干预对ET患者震颤症状的影响。我们全面检索后确定了八项使用1Hz重复经颅磁刺激（rTMS）、连续θ波刺激（cTBS）或皮层直流电刺激（ctDCS）方案的研究。对八项合格研究中的20项比较进行了统计学综合分析，荟萃分析结果显示NIBS技术可减少ET患者的震颤行为。此外，四项调节变量分析表明，NIBS的积极治疗效果出现在以下亚组中：（a）震颤评估（临床测试与定量震颤评估），（b）刺激部位（小脑与运动皮层），（c）疗程数（单次疗程与多次疗程），以及（d）持续的积极治疗效果（后测与留存测试）。这项全面的系统评价和荟萃分析提供了证据，支持NIBS技术对ET运动治疗具有积极的治疗效果。
