Repetitive transcranial magnetic stimulation on chronic tinnitus: a systematic review and meta-analysis.
Repetitive transcranial magnetic stimulation on chronic tinnitus: a systematic review and meta-analysis.
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DOI：
10.1186/s12888-020-02947-9
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发表时间：
2020-11-23
期刊：
影响因子：
4.4
通讯作者：
Jia H
中科院分区：
文献类型：
--
作者：
Liang Z;Yang H;Cheng G;Huang L;Zhang T;Jia H
虽然重复经颅磁刺激（rTMS）治疗慢性耳鸣的临床疗效和安全性已被频繁检查，结果仍然相互矛盾。因此，我们进行了系统性综述和荟萃分析临床试验，检查rTMS的影响，以评估其临床疗效和安全性。从PubMed、Embase和科克伦图书馆检索了截至2020年4月的rTMS治疗慢性耳鸣的研究。采用ReviewManager5.3软件进行数据综合，采用Stata13.0软件进行发表偏倚和敏感性分析。纳入了29项随机研究，涉及1228例慢性耳鸣患者。与假rTMS相比，rTMS在1周时耳鸣障碍量表（THI）评分中表现出显著改善（平均差[MD]：− 7.92，95%置信区间[CI]：− 14.18，− 1.66），1个月（MD：-8.52，95%CI：-12.49，-4.55）和6个月（MD：-6.53，95% CI：-11.406，-1.66）; 1个月时THI评分平均值有显著变化干预后6个月（MD：-14.86，95%CI：-21.42，-8.29）和6个月（MD：-16.37，95%CI：-20.64，-12.11），以及干预后1周的耳鸣问卷（TQ）评分（MD：-8.54，95%CI：-15.56，-1.52）。在干预后2周的THI评分方面，发现rTMS的疗效不显著（MD：-1.51，95%CI：-13.42，-10.40）;干预后1个月TQ评分的平均变化（MD：-3.67，95% CI：-8.56，1.22）; TQ评分1（MD：-8.97，95%CI：-20.41，2.48）和6个月（MD：-7.02，95%CI：-18.18，4.13）;不良事件（比值比[OR]：1.11，95%CI：0.51，2.42）。Egger和Begg检验表明无发表偏倚（P = 0.925）。这项荟萃分析表明，rTMS对慢性耳鸣有效;然而，其安全性需要更多的验证。受纳入研究数量不足和样本量小的限制，需要更多的大型随机双盲多中心试验进行进一步验证。
Although the clinical efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) in the treatment of chronic tinnitus have been frequently examined, the results remain contradictory. Therefore, we performed a systematic review and meta-analysed clinical trials examining the effects of rTMS to evaluate its clinical efficacy and safety. Studies of rTMS for chronic tinnitus were retrieved from PubMed, Embase, and Cochrane Library through April 2020. Review Manager 5.3 software was employed for data synthesis, and Stata 13.0 software was used for analyses of publication bias and sensitivity. Twenty-nine randomized studies involving 1228 chronic tinnitus patients were included. Compared with sham-rTMS, rTMS exhibited significant improvements in the tinnitus handicap inventory (THI) scores at 1 week (mean difference [MD]: − 7.92, 95% confidence interval [CI]: − 14.18, − 1.66), 1 month (MD: -8.52, 95% CI: − 12.49, − 4.55), and 6 months (MD: -6.53, 95% CI: − 11.406, − 1.66) post intervention; there were significant mean changes in THI scores at 1 month (MD: -14.86, 95% CI: − 21.42, − 8.29) and 6 months (MD: -16.37, 95% CI: − 20.64, − 12.11) post intervention, and the tinnitus questionnaire (TQ) score at 1 week post intervention (MD: -8.54, 95% CI: − 15.56, − 1.52). Nonsignificant efficacy of rTMS was found regarding the THI score 2 weeks post intervention (MD: -1.51, 95% CI: − 13.42, − 10.40); the mean change in TQ scores 1 month post intervention (MD: -3.67, 95% CI: − 8.56, 1.22); TQ scores 1 (MD: -8.97, 95% CI: − 20.41, 2.48) and 6 months (MD: -7.02, 95% CI: − 18.18, 4.13) post intervention; and adverse events (odds ratios [OR]: 1.11, 95% CI: 0.51, 2.42). Egger’s and Begg’s tests indicated no publication bias (P = 0.925). This meta-analysis demonstrated that rTMS is effective for chronic tinnitus; however, its safety needs more validation. Restrained by the insufficient number of included studies and the small sample size, more large randomized double-blind multi-centre trials are needed for further verification.
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影响因子：
2.6
作者：
Mennemeier, Mark;Chelette, Kenneth C.;Allen, Shawn;Bartel, Twyla B.;Triggs, William;Kimbrell, Timothy;Crew, Joseph;Munn, Tiffany;Brown, Ginger J.;Dornhoffer, John
通讯作者：
Dornhoffer, John
影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
7.7
作者：
James GA;Thostenson JD;Brown G;Carter G;Hayes H;Tripathi SP;Dobry DJ;Govindan RB;Dornhoffer JL;Williams DK;Kilts CD;Mennemeier MS
通讯作者：
Mennemeier MS
影响因子：
2.1
作者：
Godbehere, Joanna;Sandhu, Jaswinder;Barker, Anthony
通讯作者：
Barker, Anthony
影响因子：
5.1
作者：
Marcondes, R. A.;Sanchez, T. G.;Marcolin, M. A.
通讯作者：
Marcolin, M. A.