Effects of Repetitive Transcranial Magnetic Stimulation on Motor Functions in Patients With Stroke A Meta-Analysis
Effects of Repetitive Transcranial Magnetic Stimulation on Motor Functions in Patients With Stroke A Meta-Analysis
复制标题
DOI：
10.1161/strokeaha.111.649756
复制
发表时间：
2012-07-01
期刊：
影响因子：
8.3
通讯作者：
Lin, Yung-Yang
中科院分区：
文献类型：
--
作者：
Hsu, Wan-Yu;Cheng, Chia-Hsiung;Lin, Yung-Yang
背景和目的-本研究的目的是进行一项荟萃分析的研究，调查重复经颅磁刺激（rTMS）对上肢运动功能的中风patients. Methods的影响，我们搜索了随机对照试验发表在1990年1月和2011年10月之间的PubMed，Medline，科克伦，和CINAHL使用以下关键词：中风、脑血管意外和重复经颅磁刺激。平均效应大小和95%CI估计的运动结果和运动阈值使用固定和随机效应models.Results-Eighteen的34个候选文章被列入本分析。所选研究共涉及392例患者。发现运动结局的显著效应量为0.55（95%CI，0.37-0.72）。进一步的亚组分析表明，皮质下卒中（平均效应量，0.73; 95% CI，0.44-1.02）或应用低频rTMS的研究（平均效应量，0.69; 95% CI，0.42-0.95）的效应更为显著。只有4例患者的18篇文章，包括在本分析报告的不良反应rTMS. Conclusions-rTMS有积极的影响，运动恢复中风患者，特别是那些与皮层下中风。在未受影响的半球上进行低频rTMS可能比在受影响的半球上进行高频rTMS更有益。最近有限的数据表明，在受影响的半球的间歇性θ-爆发刺激可能是一个有用的干预。需要在更大的人群中进行进一步设计良好的研究，以更好地阐明各种rTMS方案在卒中治疗中的不同作用。（中风。2012;43：1849-1857.）
Background and Purpose-The purpose of this study was to perform a meta-analysis of studies that investigated the effects of repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function in patients with stroke.Methods-We searched for randomized controlled trials published between January 1990 and October 2011 in PubMed, Medline, Cochrane, and CINAHL using the following key words: stroke, cerebrovascular accident, and repetitive transcranial magnetic stimulation. The mean effect size and a 95% CI were estimated for the motor outcome and motor threshold using fixed and random effect models.Results-Eighteen of the 34 candidate articles were included in this analysis. The selected studies involved a total of 392 patients. A significant effect size of 0.55 was found for motor outcome (95% CI, 0.37-0.72). Further subgroup analyses demonstrated more prominent effects for subcortical stroke (mean effect size, 0.73; 95% CI, 0.44-1.02) or studies applying low-frequency rTMS (mean effect size, 0.69; 95% CI, 0.42-0.95). Only 4 patients of the 18 articles included in this analysis reported adverse effects from rTMS.Conclusions-rTMS has a positive effect on motor recovery in patients with stroke, especially for those with subcortical stroke. Low-frequency rTMS over the unaffected hemisphere may be more beneficial than high-frequency rTMS over the affected hemisphere. Recent limited data suggest that intermittent theta-burst stimulation over the affected hemisphere might be a useful intervention. Further well-designed studies in a larger population are required to better elucidate the differential roles of various rTMS protocols in stroke treatment. (Stroke. 2012;43:1849-1857.)