Optimal Parameter Analysis of Repetitive Transcranial Magnetic Stimulation on Motor Function in Patients with Incomplete Spinal Cord Injury: A Meta-Analysis.

BackgroundRepetitive transcranial magnetic stimulation (rTMS) has shown potential in rehabilitating patients with incomplete spinal cord injury (iSCI). However, the evidence is mainly based on small-scale studies with varying protocols.ObjectiveTo summarize the impact of rTMS on motor function deficits in individuals with iSCI and identify optimal stimulation parameters through a meta-analysis.MethodsA systematic literature search was conducted in multiple databases from inception to July 31, 2024. Randomized controlled trials investigating rTMS effects on motor function in iSCI were included. Study quality was assessed using the RoB 2 and PEDro scale. RESULTS: Eleven studies with 345 participants were included. rTMS applied at 100-110% of resting motor threshold (SMD = 0.81, P = 0.0005), with over 15 stimulation sessions (SMD = 0.66, P = 0.04) and a cumulative pulse count of 1800 (SMD = 0.50, P = 0.04), significantly enhanced motor function recovery in iSCI patients. Four studies reported mild, transient adverse effects in 11 patients.ConclusionrTMS may enhance motor function in iSCI patients with certain parameters. However, given study limitations, conclusions should be viewed as exploratory.