Beijing Xiaotangshan Hospital, Beijing, China.
Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin, China.
Eur J Med Res. 2024 Nov 29;29(1):568. doi: 10.1186/s40001-024-02170-2.
Stroke is the second leading cause of death and the third leading cause of disability worldwide. Motor dysfunction is a common sequela, which seriously affects the lives of patients. Theta burst stimulation (TBS) is a new transcranial magnetic therapy for improving motor dysfunction after stroke. However, there remains a lack of studies on the mechanism, theoretical model, and effectiveness of TBS in improving motor dysfunction following stroke.
This paper provides a comprehensive overview and assessment of the current impact of TBS on motor rehabilitation following stroke and analyzes potential factors contributing to treatment effect disparities. The aim is to offer recommendations for further refining the TBS treatment approach in subsequent clinical studies while also furnishing evidence for devising tailored rehabilitation plans for stroke patients.
This study was conducted following PRISMA guidelines. PubMed, Embase, Web of Science, and the Cochrane Library were searched systematically from the establishment of the database to February 2024. Relevant studies using TBS to treat patients with motor dysfunction after stroke will be included. Data on study characteristics, interventions, outcome measures, and primary outcomes were extracted. The Modified Downs and Black Checklist was used to assess the potential bias of the included studies, and a narrative synthesis of the key findings was finally conducted.
The specific mechanism of TBS in improving motor dysfunction after stroke has not been fully elucidated, but it is generally believed that TBS can improve the functional prognosis of patients by regulating motor cortical excitability, inducing neural network reorganization, and regulating cerebral circulation metabolism. Currently, most relevant clinical studies are based on the interhemispheric inhibition model (IHI), the vicariation model, and the bimodal balance-recovery model. Many studies have verified the effectiveness of TBS in improving the motor function of stroke patients, but the therapeutic effect of some studies is controversial.
Our results show that TBS has a good effect on improving motor function in stroke patients, but more large-scale, high-quality, multicenter studies are still necessary in the future to further clarify the mechanism of TBS and explore the optimal TBS treatment.
脑卒中是全球范围内第二大致死原因和第三大致残原因。运动功能障碍是常见的后遗症，严重影响患者的生活。θ爆发刺激（TBS）是一种新的经颅磁刺激治疗方法，可改善脑卒中后的运动功能障碍。然而，目前关于 TBS 改善脑卒中后运动功能障碍的机制、理论模型和疗效仍缺乏研究。
本文全面综述和评估 TBS 对脑卒中后运动康复的影响，并分析导致治疗效果差异的潜在因素。旨在为今后的临床研究进一步优化 TBS 治疗方法提供建议，同时为脑卒中患者制定个体化康复方案提供依据。
本研究按照 PRISMA 指南进行。系统检索 PubMed、Embase、Web of Science 和 Cochrane Library 从建库至 2024 年 2 月的相关文献。纳入使用 TBS 治疗脑卒中后运动功能障碍患者的研究。提取研究特征、干预措施、结局指标和主要结局数据。采用改良的 Downs 和 Black 清单评估纳入研究的潜在偏倚，并对关键发现进行叙述性综合。
TBS 改善脑卒中后运动功能障碍的具体机制尚未完全阐明，但普遍认为 TBS 通过调节运动皮质兴奋性、诱导神经网络重组和调节脑循环代谢来改善患者的功能预后。目前，大多数相关临床研究基于双侧半球抑制模型（IHI）、代偿模型和双模态平衡恢复模型。许多研究已经验证了 TBS 改善脑卒中患者运动功能的有效性，但一些研究的治疗效果存在争议。
本研究结果表明，TBS 对改善脑卒中患者的运动功能有较好的效果，但未来仍需要更多大规模、高质量、多中心的研究进一步阐明 TBS 的作用机制，并探索最佳的 TBS 治疗方案。
