Beijing Sport University, Beijing, China.
Beijing Chunlizhengda Medical Instruments Co., Ltd, Beijing, China.
Medicine (Baltimore). 2023 Sep 29;102(39):e34960. doi: 10.1097/MD.0000000000034960.
Although noninvasive brain stimulation (NIBS) techniques are an effective alternative treatment option, their relative effects in patients with Parkinson's disease (PD) remain undefined. Here, we aimed to compare motor efficacy of the NIBS techniques in PD.
We carried out an electronic search in PubMed, Embase, Cochrane Library, CINAHL, PEDro and PsycINFO (accessed via Ovid) for articles published until August 2022. The treatment efficacy of motor function was quantified by the Unified Parkinson's disease rating scale part III.
28 randomized controlled trials with parallel group were included in the analysis, enrolling 1057 patients. In the "on" state, high-frequency repetitive transcranial magnetic stimulation (HFrTMS) conferred better short-term and long-term efficacy compared to transcranial direct current stimulation. Surface under the cumulative ranking curve rank showed that HFrTMS combined with transcranial direct current stimulation and low-frequency TMS ranked first among PD in improving motor function. In the "off" state, there were no significant differences in most of the treatments, but surface under the cumulative ranking curve rank showed that continuous theta burst stimulation and low-frequency TMS had the highest short- and long-term effect in improving motor function.
HFrTMS is an effective intervention in improving motor function. Besides, its combination with another NIBS technique produces better therapeutic effects in the "on" state.
虽然非侵入性脑刺激(NIBS)技术是一种有效的替代治疗选择,但它们在帕金森病(PD)患者中的相对效果仍未确定。在这里,我们旨在比较 NIBS 技术在 PD 中的运动疗效。
我们在 PubMed、Embase、Cochrane 图书馆、CINAHL、PEDro 和 PsycINFO(通过 Ovid 访问)上进行了电子检索,以检索截至 2022 年 8 月发表的文章。运动功能的治疗效果通过统一帕金森病评定量表第 III 部分进行量化。
共有 28 项平行组随机对照试验纳入分析,共纳入 1057 名患者。在“ON”状态下,与经颅直流电刺激相比,高频重复经颅磁刺激(HFrTMS)具有更好的短期和长期疗效。累积排序曲线下面积等级显示,在改善运动功能方面,HFrTMS 联合经颅直流电刺激和低频 TMS 排名第一。在“OFF”状态下,大多数治疗方法之间没有显著差异,但累积排序曲线下面积等级显示,连续 theta 爆发刺激和低频 TMS 在改善运动功能方面具有最高的短期和长期效果。
HFrTMS 是改善运动功能的有效干预措施。此外,它与另一种 NIBS 技术联合使用在“ON”状态下产生更好的治疗效果。