重复经颅磁刺激辅助运动区对帕金森病运动功能的疗效：一项荟萃分析。
Efficacy of Repetitive Transcranial Magnetic Stimulation Over the Supplementary Motor Area on Motor Function in Parkinson's Disease: A Meta-analysis.
作者信息
Lu Qi-Qi, Zhu Ping-An, Li Zhi-Liang, Holmes Clayton, Zhong Yu, Liu Howe, Bao Xiao, Xie Ju-Ying
机构信息
From the Xiangnan University, Chenzhou, China (J-YX); Department of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, China (Q-qL, P-aZ, Z-lL, XB, JY-X); University of Jamestown, Jamestown, North Dakota, (CH); Department of Rehabilitation Medicine, Fujian Longyan First Hospital, Fujian, China (YZ); and Physical Therapy Department, Louisiana State University Health Science Center, New Orleans, Louisiana (HL).
出版信息
Am J Phys Med Rehabil. 2025 Apr 1;104(4):318-324. doi: 10.1097/PHM.0000000000002593. Epub 2024 Jun 26.
OBJECTIVE
The objective of this study was to assess the effect of repetitive transcranial magnetic stimulation on the supplementary motor area in motor function in Parkinson's disease patients.
METHOD
Databases searched included five databases from October 7, 2022, to January 4, 2023. The Cochrane Bias Risk Assessment Tool was used for quality assessment. Standardized mean differences were calculated using a random-effects model. Outcome measure is the motor function examination of the motor part of Unified Parkinson's Disease Rating Scale.
RESULTS
Seven studies totaling 374 patients were included. Meta-analysis showed that stimulation of supplementary motor area significantly improved motor function in Parkinson's disease patients compared with sham stimulation (standardized mean differences = -1.24; 95% CI, -2.24 to -0.24; P = 0.02; I2 = 93%). Stimulation of the same target (supplementary motor area) subgroup analysis showed that high-frequency repetitive transcranial magnetic stimulation is more effective than low-frequency repetitive transcranial magnetic stimulation in improving motor function in Parkinson's disease (standardized mean differences = -1.39; 95% CI, -2.21 to -0.57; P = 0.04; I2 = 77.2%).
CONCLUSIONS
Overall, repetitive transcranial magnetic stimulation over supplementary motor area had a statistically significant improvement in motor function in Parkinson's disease patients, and high-frequency repetitive transcranial magnetic stimulation is statistically significantly more effective than low-frequency repetitive transcranial magnetic stimulation.
目的
本研究旨在评估重复经颅磁刺激对帕金森病患者运动功能中辅助运动区的影响。
方法
检索的数据库包括从2022年10月7日至2023年1月4日的五个数据库。使用Cochrane偏倚风险评估工具进行质量评估。采用随机效应模型计算标准化均数差。结局指标是统一帕金森病评定量表运动部分的运动功能检查。
结果
纳入了7项研究，共374例患者。荟萃分析表明，与假刺激相比，刺激辅助运动区可显著改善帕金森病患者的运动功能（标准化均数差=-1.24；95%可信区间，-2.24至-0.24；P=0.02；I²=93%）。对同一靶点（辅助运动区）刺激的亚组分析显示，高频重复经颅磁刺激在改善帕金森病患者运动功能方面比低频重复经颅磁刺激更有效（标准化均数差=-1.39；95%可信区间，-2.21至-0.57；P=0.04；I²=77.2%）。
结论
总体而言，对辅助运动区进行重复经颅磁刺激在帕金森病患者的运动功能方面有统计学显著改善，且高频重复经颅磁刺激在统计学上比低频重复经颅磁刺激更有效。
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