Effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in Parkinson's disease: A systematic review with meta‐analysis
Abstract Background Repetitive transcranial magnetic stimulation (rTMS) is acknowledged to be crucial to manage freezing of gait (FOG) and cognitive impairment for patients with Parkinson's disease (PD), but its effectiveness is unclear. Objective To determine the effects of rTMS on FOG and cog...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | Brain and Behavior |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/brb3.2697 |
| _version_ | 1817995557970378752 |
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| author | Shan Deng Zhimei Dong Liya Pan Ying Liu Ziming Ye Lu Qin Qianqian Liu Chao Qin |
| author_facet | Shan Deng Zhimei Dong Liya Pan Ying Liu Ziming Ye Lu Qin Qianqian Liu Chao Qin |
| author_sort | Shan Deng |
| collection | DOAJ |
| description | Abstract Background Repetitive transcranial magnetic stimulation (rTMS) is acknowledged to be crucial to manage freezing of gait (FOG) and cognitive impairment for patients with Parkinson's disease (PD), but its effectiveness is unclear. Objective To determine the effects of rTMS on FOG and cognitive function in people with PD and to investigate potential factors that modulate the rTMS effects. Methods Databases searched included PubMed, Web of Science, EMBASE, and the Cochrane Library from inception to December 31, 2021. Eligible studies include a controlled randomized clinical trial of rTMS intervention for FOG and cognitive dysfunction in PD patients. The weighted mean difference (WMD) with 95% confidence intervals (CI) were calculated with fixed‐effects models. The outcome of the study included gait and cognitive assessments. Results Sixteen studies with a total of 419 patients were included. Fixed‐effects analysis revealed that rTMS was effective in improving freezing of gait questionnaire scores (short‐term effect: WMD = −0.925, 95% CI: −1.642 to −0.209, p = .011; long‐term effect: WMD = −2.120, 95% CI: −2.751 to −1.489, p = .000), 10‐m walking time (short‐term effect: WMD = −0.456, 95% CI: −0.793 to −0.119, p = .008; long‐term effect: WMD = −0.526, 95% CI: −0.885 to −0.167, p = .004), Timed Up‐and‐Go scores (short‐term effect: WMD = −1.064, 95% CI: −1.555 to −0.572, p = .000; long‐term effect: WMD = −1.097, 95% CI: −1.422 to −0.772, p = .000), Montreal cognitive assessment (WMD = 3.714, 95% CI: 2.567 to 4.861, p = .000), and frontal assessment battery (WMD = −0.584, 95% CI: −0.934 to −0.234, p = .001). Conclusions RTMS showed a beneficial effect on FOG and cognitive dysfunction in parkinsonism. However, the optimal rTMS protocol has not been determined and further high‐quality studies are needed. |
| first_indexed | 2024-04-14T02:08:57Z |
| format | Article |
| id | doaj.art-2ac7803339d940f893b9df0f42150121 |
| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-04-14T02:08:57Z |
| publishDate | 2022-08-01 |
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| series | Brain and Behavior |
| spelling | doaj.art-2ac7803339d940f893b9df0f421501212022-12-22T02:18:34ZengWileyBrain and Behavior2162-32792022-08-01128n/an/a10.1002/brb3.2697Effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in Parkinson's disease: A systematic review with meta‐analysisShan Deng0Zhimei Dong1Liya Pan2Ying Liu3Ziming Ye4Lu Qin5Qianqian Liu6Chao Qin7Department of Neurology The First Affiliated Hospital of Guangxi Medical University Nanning ChinaDepartment of Neurology The First Affiliated Hospital of Guangxi Medical University Nanning ChinaDepartment of Neurology The Fourth Affiliated Hospital of Guangxi Medical University Liuzhou ChinaDepartment of Neurology The First Affiliated Hospital of Guangxi Medical University Nanning ChinaDepartment of Neurology The First Affiliated Hospital of Guangxi Medical University Nanning ChinaDepartment of Neurology The Fourth Affiliated Hospital of Guangxi Medical University Liuzhou ChinaDepartment of Neurology The Fourth Affiliated Hospital of Guangxi Medical University Liuzhou ChinaDepartment of Neurology The First Affiliated Hospital of Guangxi Medical University Nanning ChinaAbstract Background Repetitive transcranial magnetic stimulation (rTMS) is acknowledged to be crucial to manage freezing of gait (FOG) and cognitive impairment for patients with Parkinson's disease (PD), but its effectiveness is unclear. Objective To determine the effects of rTMS on FOG and cognitive function in people with PD and to investigate potential factors that modulate the rTMS effects. Methods Databases searched included PubMed, Web of Science, EMBASE, and the Cochrane Library from inception to December 31, 2021. Eligible studies include a controlled randomized clinical trial of rTMS intervention for FOG and cognitive dysfunction in PD patients. The weighted mean difference (WMD) with 95% confidence intervals (CI) were calculated with fixed‐effects models. The outcome of the study included gait and cognitive assessments. Results Sixteen studies with a total of 419 patients were included. Fixed‐effects analysis revealed that rTMS was effective in improving freezing of gait questionnaire scores (short‐term effect: WMD = −0.925, 95% CI: −1.642 to −0.209, p = .011; long‐term effect: WMD = −2.120, 95% CI: −2.751 to −1.489, p = .000), 10‐m walking time (short‐term effect: WMD = −0.456, 95% CI: −0.793 to −0.119, p = .008; long‐term effect: WMD = −0.526, 95% CI: −0.885 to −0.167, p = .004), Timed Up‐and‐Go scores (short‐term effect: WMD = −1.064, 95% CI: −1.555 to −0.572, p = .000; long‐term effect: WMD = −1.097, 95% CI: −1.422 to −0.772, p = .000), Montreal cognitive assessment (WMD = 3.714, 95% CI: 2.567 to 4.861, p = .000), and frontal assessment battery (WMD = −0.584, 95% CI: −0.934 to −0.234, p = .001). Conclusions RTMS showed a beneficial effect on FOG and cognitive dysfunction in parkinsonism. However, the optimal rTMS protocol has not been determined and further high‐quality studies are needed.https://doi.org/10.1002/brb3.2697cognitive dysfunctionfreezing of gaitmeta‐analysisParkinson's diseasetranscranial magnetic stimulation |
| spellingShingle | Shan Deng Zhimei Dong Liya Pan Ying Liu Ziming Ye Lu Qin Qianqian Liu Chao Qin Effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in Parkinson's disease: A systematic review with meta‐analysis Brain and Behavior cognitive dysfunction freezing of gait meta‐analysis Parkinson's disease transcranial magnetic stimulation |
| title | Effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in Parkinson's disease: A systematic review with meta‐analysis |
| title_full | Effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in Parkinson's disease: A systematic review with meta‐analysis |
| title_fullStr | Effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in Parkinson's disease: A systematic review with meta‐analysis |
| title_full_unstemmed | Effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in Parkinson's disease: A systematic review with meta‐analysis |
| title_short | Effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in Parkinson's disease: A systematic review with meta‐analysis |
| title_sort | effects of repetitive transcranial magnetic stimulation on gait disorders and cognitive dysfunction in parkinson s disease a systematic review with meta analysis |
| topic | cognitive dysfunction freezing of gait meta‐analysis Parkinson's disease transcranial magnetic stimulation |
| url | https://doi.org/10.1002/brb3.2697 |
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