Faculty of Rehabilitation, Shijonawate Gakuen University, Daito, Japan
Department of Rehabilitation, School of Nursing and Rehabilitation Sciences, Showa University, Midoriku, Yokohama-shi, Kanagawa, Japan.
BMJ Open. 2023 Jun 29;13(6):e073526. doi: 10.1136/bmjopen-2023-073526.
To date, the medical and rehabilitation needs of people with degenerative cerebellar ataxia (DCA) are not fully met because no curative treatment has yet been established. Movement disorders such as cerebellar ataxia and balance and gait disturbance are common symptoms of DCA. Recently, non-invasive brain stimulation (NIBS) techniques, including repetitive transcranial magnetic stimulation and transcranial electrical stimulation, have been reported as possible intervention methods to improve cerebellar ataxia. However, evidence of the effects of NIBS on cerebellar ataxia, gait ability, and activity of daily living is insufficient. This study will aim to systematically evaluate the clinical effects of NIBS on patients with DCA.
We will conduct a preregistered systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We will include randomised controlled trials to assess the effects of NIBS on patients with DCA. The primary clinical outcome will be cerebellar ataxia, as measured by the Scale for Assessment and Rating of Ataxia and the International Cooperative Ataxia Rating Scale. The secondary outcomes will include gait speed, functional ambulatory capacity and functional independence measure, as well as any other reported outcomes that the reviewer considers important. The following databases will be searched: PubMed, Cochrane Central Register of Controlled Trials, CINAHL and PEDro. We will assess the strength of the evidence included in the studies and estimate the effects of NIBS.
Because of the nature of systematic reviews, no ethical issues are anticipated. This systematic review will provide evidence on the effects of NIBS in patients with DCA. The findings of this review are expected to contribute to clinical decision-making towards selecting NIBS techniques for treatment and generating new clinical questions to be addressed.
CRD42023379192.
迄今为止，由于尚未确定治愈退行性小脑共济失调 (DCA) 的方法，因此人们的医学和康复需求尚未得到充分满足。共济失调和平衡及步态障碍等运动障碍是 DCA 的常见症状。最近，包括重复经颅磁刺激和经颅电刺激在内的非侵入性脑刺激 (NIBS) 技术已被报道为改善小脑共济失调的可能干预方法。但是，NIBS 对小脑共济失调、步态能力和日常生活活动的影响的证据还不够充分。本研究旨在系统评估 NIBS 对 DCA 患者的临床效果。
我们将根据《系统评价和荟萃分析报告的首选项目》声明进行预先注册的系统评价和荟萃分析。我们将纳入随机对照试验，以评估 NIBS 对 DCA 患者的影响。主要临床结局将是小脑共济失调，通过共济失调评估和评分量表以及国际合作共济失调评分量表进行测量。次要结局将包括步态速度、功能性步行能力和功能性独立性测量，以及审查员认为重要的任何其他报告结局。将搜索以下数据库：PubMed、Cochrane 对照试验中心注册库、CINAHL 和 PEDro。我们将评估纳入研究的证据强度并估计 NIBS 的效果。
由于系统评价的性质，预计不会出现伦理问题。本系统评价将提供关于 NIBS 对 DCA 患者影响的证据。预计本综述的结果将有助于临床决策，选择 NIBS 技术进行治疗，并产生有待解决的新的临床问题。
PROSPERO 注册号：CRD42023379192。
