重复经颅磁刺激改善帕金森病患者的认知、抑郁和行走能力：一项荟萃分析。
Repetitive transcranial magnetic stimulation improves cognition, depression, and walking ability in patients with Parkinson's disease: a meta-analysis.
作者信息
Wang Mingchen, Zhang Wenyu, Zang Wanli
机构信息
Cangzhou Hopsital of Integrated Traditional Chinese and Western of Hebei Province, Cangzhou, Hebei, 061000, China.
Hebei Province Key Laboratory of Integrated Traditional and Western Medicine in Neurological Rehabilitation, Cangzhou, Hebei, China.
出版信息
BMC Neurol. 2024 Dec 24;24(1):490. doi: 10.1186/s12883-024-03990-9.
OBJECTIVE
To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on cognitive function, depression, and walking ability in patients with Parkinson's disease.
METHODS
A comprehensive search was conducted in PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database, and Wanfang Database. Randomized controlled trials (RCTs) on rTMS treatment in Parkinson's disease patients were retrieved, covering the period from the inception of each database to July 2024. The quality of the included studies was assessed using the Cochrane risk of bias tool. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the studies. Data synthesis and analysis were performed using RevMan 5.4 and Stata 17.0 software.
RESULTS
A total of 15 studies were included. The meta-analysis revealed that rTMS significantly improved the MOCA score (MD = 2.98, 95% CI 2.08, 3.88, P = 0.000), TUGT score (SMD=-0.72, 95% CI -1.43, 0.00, P = 0.048), FOG-Q score (SMD=-0.54, 95% CI -0.97, -0.11, P = 0.01), and UPDRS-III score (SMD=-0.66, 95% CI -0.84, -0.47, P = 0.000) in Parkinson's disease patients, and also alleviated depressive symptoms as measured by the HAMD (SMD=-0.43, 95% CI -0.72, -0.13, P = 0.004).
CONCLUSIONS
rTMS can improve cognitive function, depressive symptoms, and walking ability in patients with Parkinson's disease.
目的
评估重复经颅磁刺激（rTMS）对帕金森病患者认知功能、抑郁及行走能力的疗效。
方法
在PubMed、Web of Science、Embase、Cochrane图书馆、中国知网（CNKI）、中国生物医学文献数据库（CBM）、维普数据库和万方数据库中进行全面检索。检索帕金森病患者rTMS治疗的随机对照试验（RCT），涵盖各数据库建库至2024年7月期间。使用Cochrane偏倚风险工具评估纳入研究的质量。两名研究人员独立筛选文献、提取数据并评估研究中的偏倚风险。使用RevMan 5.4和Stata 17.0软件进行数据合成与分析。
结果
共纳入15项研究。荟萃分析显示，rTMS显著提高了帕金森病患者的蒙特利尔认知评估量表（MOCA）评分（MD = 2.98，95%CI 2.08，3.88，P = 0.000）、定时起立-行走测试（TUGT）评分（SMD = -0.72，95%CI -1.43，0.00，P = 0.048）、冻结步态问卷（FOG-Q）评分（SMD = -0.54，95%CI -0.97，-0.11，P = 0.01）和统一帕金森病评定量表第三部分（UPDRS-III）评分（SMD = -0.66，95%CI -0.84，-0.47，P = 0.000），并减轻了汉密尔顿抑郁量表（HAMD）测量的抑郁症状（SMD = -0.43，95%CI -0.72，-0.13，P = 0.004）。
结论
rTMS可改善帕金森病患者的认知功能、抑郁症状和行走能力。
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