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经颅磁刺激对小脑共济失调的影响:一项系统评价和荟萃分析。

Effects of transcranial magnetic stimulation on cerebellar ataxia: A systematic review and meta-analysis.

作者信息

Wang Ying, Zhang Di, Wang Ju, Ma Jiang, Lu Li, Jin Song

机构信息

School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

Department of Rehabilitation, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

出版信息

Front Neurol. 2023 Jan 27;14:1049813. doi: 10.3389/fneur.2023.1049813. eCollection 2023.

Abstract

OBJECTIVE

To determine the effectiveness of transcranial magnetic stimulation in improving cerebellar ataxia.

DATA SOURCES

PubMed, EMBASE, the Cochrane Library, Springer, Science Direct, the China National Knowledge Infrastructure (CNKI) and the China Science and Technology Journal Database (VIP) were searched until 2022.

REVIEW METHODS

Trials with transcranial magnetic stimulation on the effects on cerebellar ataxia were included, and the effect size was evaluated using the standardized mean difference (SMD) or mean difference (MD) and a 95% confidence interval (CI).

RESULTS

Eight studies comprising 272 participants, published between 2014 and 2022, were included. The results revealed that the effect of TMS on patients with cerebellar ataxia as assessed by the International Cooperative Ataxia Rating Scale (ICRAS), the Scale for the Assessment and Rating of Ataxia (SARA), the Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test was statistically significant ( < 0.01) with low heterogeneity among the studies (I = 4, 27, 0, and 0% respectively).

CONCLUSION

The effects of transcranial magnetic stimulation in improving cerebellar ataxia in the affected patients are significant. TMS targeting the cerebellar structures can induce changes in the excitability of the cerebellar-thalamus-cortical pathways; thus, it is necessary to carry out large-scale research with good design and high quality in the future.

摘要

目的

确定经颅磁刺激改善小脑共济失调的有效性。

资料来源

检索了截至2022年的PubMed、EMBASE、Cochrane图书馆、Springer、Science Direct、中国知网(CNKI)和中文科技期刊数据库(维普)。

综述方法

纳入经颅磁刺激对小脑共济失调影响的试验,并使用标准化均数差(SMD)或均数差(MD)及95%置信区间(CI)评估效应大小。

结果

纳入了2014年至2022年发表的8项研究,共272名参与者。结果显示,经颅磁刺激对小脑共济失调患者的影响,通过国际合作共济失调评定量表(ICRAS)、共济失调评估与分级量表(SARA)、伯格平衡量表(BBS)和计时起立行走测试(TUG)评估具有统计学意义(<0.01),各研究间异质性较低(I分别为4%、27%、0%和0%)。

结论

经颅磁刺激对改善患小脑共济失调患者的效果显著。针对小脑结构的经颅磁刺激可诱导小脑-丘脑-皮质通路兴奋性改变;因此,未来有必要开展设计良好、高质量的大规模研究。

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