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间歇性theta波爆发刺激与高频重复经颅磁刺激治疗中风后功能障碍的比较:基于贝叶斯模型的随机对照试验网络荟萃分析

Intermittent theta burst stimulation vs. high-frequency repetitive transcranial magnetic stimulation for post-stroke dysfunction: a Bayesian model-based network meta-analysis of RCTs.

作者信息

Huang Yanbing, Li Caihui, Cai Rongda, Lin Tianlai, Chen Weiwen

机构信息

Department of Critical Care Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian Province, 362000, China.

Quanzhou First Hospital Affiliated to Fujian Medical University, No.250 East Street, Licheng District, Quanzhou, Fujian Province, 362000, China.

出版信息

Neurol Sci. 2025 Apr;46(4):1525-1539. doi: 10.1007/s10072-024-07918-6. Epub 2024 Dec 21.


DOI:10.1007/s10072-024-07918-6
PMID:39707110
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11919949/
Abstract

OBJECTIVE: This research aims to comprehensively assess the efficacy of intermittent theta-burst stimulation (iTBS) vs. high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) in post-stroke dysfunction. MATERIALS AND METHODS: Until January 2024, extensive electronic database searches were conducted (PubMed, Embase, Cochrane Library, Web of Science, etc.). Fugl-Meyer Assessment for Upper Extremities (FMA-UE) was used to assess upper limb (UL) dysfunction; post-stroke dysphagia (PSD) was identified by Standardized Swallowing Assessment (SSA), Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), and Penetration/Aspiration Scale (PAS). Results were analyzed by network meta-analysis (NMA), and the mean difference (MD) and 95% confidence intervals (95% CI) were also reported. We conducted a descriptive analysis due to the inability to synthesize data on post-stroke cognitive impairment (PSCI). RESULTS: 19 studies were included for NMA analysis. For UL disorder, the efficacy of treatments was ranked as HF-rTMS [MD (95%CI):3.00 (1.69,4.31)], iTBS [MD (95%CI): 2.16 (0.84, 3.50)], and sham stimulation (reference). For PSD, the efficacy of treatment to reduce scores of FEDSS or SSA were iTBS [FEDSS, MD (95%CI): -0.80 (-1.13, -0.47); SSA, MD (95%CI): -3.37 (-4.36, -2.38)], HF-rTMS [FEDSS, MD (95%CI): -0.43 (-0.76, -0.10); SSA, MD (95%CI): -2.62 (-3.91, -1.35)], and sham stimulation(reference). Descriptive analysis of PSCI found that both iTBS and HF-rTMS were effective in improving PSCI. CONCLUSIONS: HF-rTMS demonstrates superior efficacy in UL dysfunction, while iTBS is more effective in PSD. Clinicians should carefully evaluate the type and severity of post-stroke dysfunction in each patient to select the most appropriate treatment.

摘要

目的:本研究旨在全面评估间歇性theta波爆发刺激(iTBS)与高频重复经颅磁刺激(HF-rTMS)对中风后功能障碍的疗效。 材料与方法:截至2024年1月,进行了广泛的电子数据库检索(PubMed、Embase、Cochrane图书馆、Web of Science等)。采用上肢Fugl-Meyer评估量表(FMA-UE)评估上肢(UL)功能障碍;通过标准化吞咽评估(SSA)、纤维内镜吞咽困难严重程度量表(FEDSS)和渗透/误吸量表(PAS)来识别中风后吞咽困难(PSD)。结果通过网络荟萃分析(NMA)进行分析,并报告平均差(MD)和95%置信区间(95%CI)。由于无法综合中风后认知障碍(PSCI)的数据,我们进行了描述性分析。 结果:纳入19项研究进行NMA分析。对于UL功能障碍,治疗效果排序为HF-rTMS [MD(95%CI):3.00(1.69,4.31)]、iTBS [MD(95%CI):2.16(0.84,3.50)]和假刺激(参照)。对于PSD,降低FEDSS或SSA评分的治疗效果为iTBS [FEDSS,MD(95%CI):-0.80(-1.13,-0.47);SSA,MD(95%CI):-3.37(-4.36,-2.38)]、HF-rTMS [FEDSS,MD(95%CI):-0.43(-0.76,-0.10);SSA,MD(95%CI):-2.62(-3.91,-1.35)]和假刺激(参照)。对PSCI的描述性分析发现,iTBS和HF-rTMS在改善PSCI方面均有效。 结论:HF-rTMS在UL功能障碍方面显示出更优的疗效,而iTBS在PSD方面更有效。临床医生应仔细评估每位患者中风后功能障碍的类型和严重程度,以选择最合适的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d68/11919949/67597813b885/10072_2024_7918_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d68/11919949/adf9a5653929/10072_2024_7918_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d68/11919949/f98272ea51e8/10072_2024_7918_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d68/11919949/67597813b885/10072_2024_7918_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d68/11919949/adf9a5653929/10072_2024_7918_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d68/11919949/f98272ea51e8/10072_2024_7918_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d68/11919949/67597813b885/10072_2024_7918_Fig3_HTML.jpg

相似文献

[1]
Intermittent theta burst stimulation vs. high-frequency repetitive transcranial magnetic stimulation for post-stroke dysfunction: a Bayesian model-based network meta-analysis of RCTs.

Neurol Sci. 2025-4

[2]
Evidence for Intermittent Theta Burst Transcranial Magnetic Stimulation for Dysphagia after Stroke: A Systematic Review and Meta-analysis.

Dysphagia. 2025-2

[3]
Bilateral Cerebellar Intermittent Theta Burst Stimulation Combined With Swallowing Speech Therapy for Dysphagia After Stroke: A Randomized, Double-Blind, Sham-Controlled, Clinical Trial.

Neurorehabil Neural Repair. 2022-7

[4]
Comparative efficacy of different noninvasive brain stimulation protocols on upper-extremity motor function and activities of daily living after stroke: a systematic review and network meta-analysis.

Neurol Sci. 2024-8

[5]
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Front Neurol. 2022-6-15

[6]
Effects of Cerebellar Repetitive Transcranial Magnetic Stimulation in the Treatment of Post-Stroke Dysphagia: A Meta-Analysis and Systematic Review of Randomized Controlled Trials.

Eur Neurol. 2024

[7]
Theta-burst transcranial magnetic stimulation for dysphagia patients during recovery stage of stroke: a randomized controlled trial.

Eur J Phys Rehabil Med. 2023-10

[8]
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BMJ Open. 2025-4-27

[9]
Theta burst stimulation versus high-frequency repetitive transcranial magnetic stimulation for poststroke dysphagia: A randomized, double-blind, controlled trial.

Medicine (Baltimore). 2022-1-14

[10]
Efficacy and Safety of Intermittent Theta Burst Stimulation and High-Frequency Repetitive Transcranial Magnetic Stimulation for Major Depressive Disorder: A Systematic Meta-Analysis.

Br J Hosp Med (Lond). 2024-8-30

本文引用的文献

[1]
Correction to: Evidence for Intermittent Theta Burst Transcranial Magnetic Stimulation for Dysphagia After Stroke: A Systematic Review and Meta-analysis.

Dysphagia. 2025-2

[2]
Evidence for Intermittent Theta Burst Transcranial Magnetic Stimulation for Dysphagia after Stroke: A Systematic Review and Meta-analysis.

Dysphagia. 2025-2

[3]
The effect of transcranial magnetic stimulation on cognitive function in post-stroke patients: a systematic review and meta-analysis.

BMC Neurol. 2024-7-5

[4]
Effects of Combined Use of Intermittent Theta Burst Stimulation and Cognitive Training on Poststroke Cognitive Impairment: A Single-Blind Randomized Controlled Trial.

Am J Phys Med Rehabil. 2024-4-1

[5]
Theta-burst transcranial magnetic stimulation for dysphagia patients during recovery stage of stroke: a randomized controlled trial.

Eur J Phys Rehabil Med. 2023-10

[6]
Immediate Effects of Intermittent Theta Burst Stimulation on Primary Motor Cortex in Stroke Patients: A Concurrent TMS-EEG Study.

IEEE Trans Neural Syst Rehabil Eng. 2023

[7]
The effects of intermittent theta burst stimulation of the unilateral cerebellar hemisphere on swallowing-related brain regions in healthy subjects.

Front Hum Neurosci. 2023-3-30

[8]
Microglial Cytokines Mediate Plasticity Induced by 10 Hz Repetitive Magnetic Stimulation.

J Neurosci. 2023-4-26

[9]
Effect of Repetitive Transcranial Magnetic Stimulation in Post-stroke Patients with Severe Upper-Limb Motor Impairment.

Brain Neurorehabil. 2019-10-24

[10]
Cerebral activity manipulation of low-frequency repetitive transcranial magnetic stimulation in post-stroke patients with cognitive impairment.

Front Neurol. 2022-11-8

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