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不同频率重复经颅磁刺激对脑卒中后失语症的影响:一项遵循PRISMA标准的Meta分析。

Effects of repetitive transcranial magnetic stimulation with different frequencies on post-stroke aphasia: A PRISMA-compliant meta-analysis.

作者信息

Li Tiao, Zeng Xiaoxiang, Lin Lijuan, Xian Tingting, Chen Zhuoming

机构信息

The First Affiliated Hospital of Jinan University, Guangzhou.

Department of Rehabilitation Medicine, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai.

出版信息

Medicine (Baltimore). 2020 Jun 12;99(24):e20439. doi: 10.1097/MD.0000000000020439.

Abstract

BACKGROUNDS

Previous studies indicated inconsistent results for the treatment effect of repetitive transcranial magnetic stimulation (rTMS) on post-stroke aphasics. The study conducted a meta-analysis to evaluate whether the rTMS with different frequencies demonstrated any effect in patients with post-stroke aphasia.

METHODS

Electronic databases (PubMed, Web of Science, Medline, EMBASE, and Google Scholar) were searched for articles published before July 2019. Statistical analyses were made using STATA 12.0 software. Standard mean difference (SMD) with 95% confidence intervals (CI) were calculated for the treatment effect of rTMS on post-stroke aphasia.

RESULTS

Meta-analysis indicated significant treatment effects on naming of rTMS in post-stroke aphasics (SMD 0.76, 95%CI 0.16 to 1.36, I = 76.9%, P < .001). Subgroup analyses showed significant treatment effects on naming of low frequency (LF)-rTMS (SMD 0.40, 95%CI 0.10 to 0.69, I = 0.0%, P = .671). However, the changes in repetition and comprehension following stimulation were not significant.

CONCLUSIONS

In conclusion, we provide preliminary evidence that both LF-rTMS and high-frequency-rTMS might be relatively effective and safe treatment for post-stroke aphasics. However, LF-rTMS mainly plays a short-term role in subacute post-stroke aphasics. Longer-term and large-scale studies are essential to explore the effect of rTMS with different frequencies on post-stroke aphasia.

摘要

背景

先前的研究表明,重复经颅磁刺激(rTMS)对脑卒中后失语症患者的治疗效果存在不一致的结果。本研究进行了一项荟萃分析,以评估不同频率的rTMS对脑卒中后失语症患者是否有任何效果。

方法

检索电子数据库(PubMed、科学网、Medline、EMBASE和谷歌学术)中2019年7月之前发表的文章。使用STATA 12.0软件进行统计分析。计算rTMS对脑卒中后失语症治疗效果的标准平均差(SMD)及95%置信区间(CI)。

结果

荟萃分析表明,rTMS对脑卒中后失语症患者的命名有显著治疗效果(SMD 0.76,95%CI 0.16至1.36,I = 76.9%,P < .001)。亚组分析显示,低频(LF)-rTMS对命名有显著治疗效果(SMD 0.40,95%CI 0.10至0.69,I = 0.0%,P = .671)。然而,刺激后复述和理解方面的变化不显著。

结论

总之,我们提供了初步证据,表明LF-rTMS和高频rTMS对脑卒中后失语症患者可能是相对有效和安全的治疗方法。然而,LF-rTMS主要在脑卒中后亚急性失语症患者中发挥短期作用。开展长期和大规模研究对于探索不同频率的rTMS对脑卒中后失语症的影响至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40f/7302648/2badc7c6e06c/medi-99-e20439-g001.jpg

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