From the China Medical University Hospital, Taichung, Taiwan (F-AY); Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan (C-LL, S-YC, T-IH, P-YY); and School of Medicine, China Medical University Hospital, Taichung, Taiwan (I-LC, P-YY).
Am J Phys Med Rehabil. 2023 Jun 1;102(6):522-532. doi: 10.1097/PHM.0000000000002151. Epub 2022 Nov 18.
This systematic review and meta-analysis aimed to assess the effects of repetitive transcranial magnetic stimulation and select a suitable protocol for poststroke visuospatial neglect.
PubMed, Cochrane Library, and Embase databases were searched for relevant studies from the inception date to October 31, 2021. The inclusion criteria were (1) randomized controlled trials, (2) people with visuospatial neglect, (3) treatment with different repetitive transcranial magnetic stimulation protocols, (4) comparison with sham or blank control, and (5) reports of performance measurements.
Data were obtained from 11 randomized controlled trials. The effects of immediate and 1-mo postintervention were measured using line bisection test, cancellation test, and Catherine Bergego Scale. Results showed statistically significant improvement when applying low-frequency (0.5-1 Hz) repetitive transcranial magnetic stimulation or continuous theta burst stimulation to the left hemisphere on short- and long-term line bisection test (standardized mean difference = -1.10, 95% confidence interval = -1.84 to -0.37; standardized mean difference = -1.25, 95% confidence interval = -2.11 to -0.39) and cancellation test (standardized mean difference = 1.08, 95% confidence interval = 0.45 to 1.71; standardized mean difference = 1.45, 95% confidence interval = 0.42, 2.47).
Repetitive transcranial magnetic stimulation may be considered a treatment option for poststroke visuospatial neglect. This review proves that a decrease in neuronal excitation in the left hemisphere, which restores the interhemispheric balance, benefits poststroke visuospatial neglect.
本系统评价和荟萃分析旨在评估重复经颅磁刺激的效果，并为脑卒中后视觉空间忽略选择合适的方案。
从建库至 2021 年 10 月 31 日，检索 PubMed、Cochrane 图书馆和 Embase 数据库中相关研究。纳入标准为：（1）随机对照试验；（2）视觉空间忽略患者；（3）采用不同重复经颅磁刺激方案治疗；（4）与假刺激或空白对照比较；（5）报告有行为学测量结果。
共纳入 11 项随机对照试验。采用线段划消测验、删除测验和 Catherine Bergego 量表测量即刻和 1 个月干预后的效果。结果显示，左半球应用低频（0.5-1 Hz）重复经颅磁刺激或连续 theta 爆发刺激，在短期和长期线段划消测验（标准化均数差=-1.10，95%置信区间=-1.84 至-0.37；标准化均数差=-1.25，95%置信区间=-2.11 至-0.39）和删除测验（标准化均数差=1.08，95%置信区间=0.45 至 1.71；标准化均数差=1.45，95%置信区间=0.42，2.47）中具有统计学意义的改善。
重复经颅磁刺激可作为脑卒中后视觉空间忽略的治疗选择。本综述证明，降低左半球神经元兴奋度以恢复半球间平衡有利于脑卒中后视觉空间忽略的恢复。
