Bishay Andrew A E D, Guo Anton, Desai Rhea, Mushinski Samuel, Au Andy, Swenson Andrew J, Iacoboni Marco, Bystritsky Alexander, Spivak Norman M
Physiological Sciences Interdepartmental Program, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
NeuroSci. 2024 Nov 5;5(4):523-533. doi: 10.3390/neurosci5040038.
Essential tremor (ET) is a prevalent movement disorder characterized by action tremors, predominantly affecting the upper limbs. While various pharmacological and non-pharmacological interventions have shown efficacy in managing ET, the therapeutic role of repetitive transcranial magnetic stimulation (rTMS) remains uncertain. This systematic review synthesizes evidence from clinical trials investigating rTMS as a treatment for ET. Despite some open-label trials reporting reductions in tremor severity, double-blinded studies revealed no significant difference between active and sham rTMS, suggesting a strong placebo effect. The findings indicate that while rTMS can reduce tremor scores, its therapeutic efficacy in ET remains unproven. Future research should focus on improving sham designs and conducting larger, rigorously controlled trials to clarify rTMS's role in ET management. Current evidence supports considering alternative treatments, such as deep brain stimulation, over rTMS for ET.
特发性震颤（ET）是一种常见的运动障碍，其特征为动作性震颤，主要影响上肢。虽然各种药物和非药物干预措施在管理ET方面已显示出疗效，但重复经颅磁刺激（rTMS）的治疗作用仍不确定。本系统评价综合了来自临床试验的证据，这些试验研究了rTMS作为ET治疗方法的效果。尽管一些开放标签试验报告震颤严重程度有所降低，但双盲研究显示，主动rTMS与假rTMS之间无显著差异，提示存在较强的安慰剂效应。研究结果表明，虽然rTMS可降低震颤评分，但其在ET中的治疗效果仍未得到证实。未来的研究应侧重于改进假刺激设计，并开展更大规模、严格对照的试验，以阐明rTMS在ET管理中的作用。目前的证据支持在ET治疗中，考虑采用深部脑刺激等替代治疗方法，而非rTMS。
