Yuan Xia, Haili Wan, Xin Hu, Wenhui Sun, Yongjie Li
{"title":"不同频率重复经颅磁刺激对帕金森病患者睡眠障碍和抑郁的影响：系统综述和网络荟萃分析","authors":"Yuan Xia, Haili Wan, Xin Hu, Wenhui Sun, Yongjie Li","doi":"10.3389/fnagi.2025.1623917","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising neuromodulatory approach for alleviating sleep disturbances and depressive symptoms in Parkinson's disease (PD), yet direct comparisons of different stimulation frequencies remain scarce.</p><p><strong>Objective: </strong>To evaluate and rank the efficacy of three rTMS frequencies (1 Hz, 5 Hz, and 10 Hz), each combined with conventional therapy, on sleep disorders and depression in PD patients, thereby informing clinical decision-making.</p><p><strong>Methods: </strong>We conducted a systematic search for randomized controlled trials (RCTs) in PubMed, Embase, the Cochrane Library, Web of Science, ProQuest, China National Knowledge Infrastructure, Wanfang, and the Chinese Scientific and Journal Database. A network meta-analysis was performed to compare the effects of different frequencies of rTMS (1 Hz, 5 Hz, and 10 Hz) on sleep disorders and depression in PD patients.</p><p><strong>Results: </strong>Thirty-one RCTs involving 1,977 PD patients met inclusion criteria. Compared with conventional treatment alone, adjunctive 5 Hz and 10 Hz rTMS produced significant improvements in both Pittsburgh Sleep Quality Index (PSQI) and Parkinson's Disease Sleep Scale (PDSS). Although 1 Hz rTMS yielded numerically greater PSQI and PDSS improvements than conventional therapy, these differences did not reach statistical significance, nor did differences between the three stimulation frequencies. In terms of depressive symptoms, all three frequencies (1 Hz, 5 Hz, and 10 Hz) significantly reduced HAMD scores versus standard care, with head-to-head comparisons indicating superior efficacy of 10 Hz over 1 Hz and 5 Hz. The Surface Under the Cumulative Ranking area (SUCRA) consistently identified 10 Hz rTMS as the most effective frequency for PSQI, PDSS, and HAMD outcomes.</p><p><strong>Conclusion: </strong>Adjunctive rTMS at 1 Hz, 5 Hz, and 10 Hz each confer benefits for sleep and mood in PD patients, but 10 Hz stimulation appears to offer the greatest overall improvement. These findings support the preferential use of 10 Hz rTMS when targeting non-motor symptoms in Parkinson's disease.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/recorddashboard, identifier CRD42024614337.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1623917"},"PeriodicalIF":4.5000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451044/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effects of different frequencies of repetitive transcranial magnetic stimulation on sleep disorders and depression in patients with Parkinson's disease: a systematic review and network meta-analysis.\",\"authors\":\"Yuan Xia, Haili Wan, Xin Hu, Wenhui Sun, Yongjie Li\",\"doi\":\"10.3389/fnagi.2025.1623917\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising neuromodulatory approach for alleviating sleep disturbances and depressive symptoms in Parkinson's disease (PD), yet direct comparisons of different stimulation frequencies remain scarce.</p><p><strong>Objective: </strong>To evaluate and rank the efficacy of three rTMS frequencies (1 Hz, 5 Hz, and 10 Hz), each combined with conventional therapy, on sleep disorders and depression in PD patients, thereby informing clinical decision-making.</p><p><strong>Methods: </strong>We conducted a systematic search for randomized controlled trials (RCTs) in PubMed, Embase, the Cochrane Library, Web of Science, ProQuest, China National Knowledge Infrastructure, Wanfang, and the Chinese Scientific and Journal Database. A network meta-analysis was performed to compare the effects of different frequencies of rTMS (1 Hz, 5 Hz, and 10 Hz) on sleep disorders and depression in PD patients.</p><p><strong>Results: </strong>Thirty-one RCTs involving 1,977 PD patients met inclusion criteria. Compared with conventional treatment alone, adjunctive 5 Hz and 10 Hz rTMS produced significant improvements in both Pittsburgh Sleep Quality Index (PSQI) and Parkinson's Disease Sleep Scale (PDSS). Although 1 Hz rTMS yielded numerically greater PSQI and PDSS improvements than conventional therapy, these differences did not reach statistical significance, nor did differences between the three stimulation frequencies. In terms of depressive symptoms, all three frequencies (1 Hz, 5 Hz, and 10 Hz) significantly reduced HAMD scores versus standard care, with head-to-head comparisons indicating superior efficacy of 10 Hz over 1 Hz and 5 Hz. The Surface Under the Cumulative Ranking area (SUCRA) consistently identified 10 Hz rTMS as the most effective frequency for PSQI, PDSS, and HAMD outcomes.</p><p><strong>Conclusion: </strong>Adjunctive rTMS at 1 Hz, 5 Hz, and 10 Hz each confer benefits for sleep and mood in PD patients, but 10 Hz stimulation appears to offer the greatest overall improvement. 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Effects of different frequencies of repetitive transcranial magnetic stimulation on sleep disorders and depression in patients with Parkinson's disease: a systematic review and network meta-analysis.
Background: Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising neuromodulatory approach for alleviating sleep disturbances and depressive symptoms in Parkinson's disease (PD), yet direct comparisons of different stimulation frequencies remain scarce.
Objective: To evaluate and rank the efficacy of three rTMS frequencies (1 Hz, 5 Hz, and 10 Hz), each combined with conventional therapy, on sleep disorders and depression in PD patients, thereby informing clinical decision-making.
Methods: We conducted a systematic search for randomized controlled trials (RCTs) in PubMed, Embase, the Cochrane Library, Web of Science, ProQuest, China National Knowledge Infrastructure, Wanfang, and the Chinese Scientific and Journal Database. A network meta-analysis was performed to compare the effects of different frequencies of rTMS (1 Hz, 5 Hz, and 10 Hz) on sleep disorders and depression in PD patients.
Results: Thirty-one RCTs involving 1,977 PD patients met inclusion criteria. Compared with conventional treatment alone, adjunctive 5 Hz and 10 Hz rTMS produced significant improvements in both Pittsburgh Sleep Quality Index (PSQI) and Parkinson's Disease Sleep Scale (PDSS). Although 1 Hz rTMS yielded numerically greater PSQI and PDSS improvements than conventional therapy, these differences did not reach statistical significance, nor did differences between the three stimulation frequencies. In terms of depressive symptoms, all three frequencies (1 Hz, 5 Hz, and 10 Hz) significantly reduced HAMD scores versus standard care, with head-to-head comparisons indicating superior efficacy of 10 Hz over 1 Hz and 5 Hz. The Surface Under the Cumulative Ranking area (SUCRA) consistently identified 10 Hz rTMS as the most effective frequency for PSQI, PDSS, and HAMD outcomes.
Conclusion: Adjunctive rTMS at 1 Hz, 5 Hz, and 10 Hz each confer benefits for sleep and mood in PD patients, but 10 Hz stimulation appears to offer the greatest overall improvement. These findings support the preferential use of 10 Hz rTMS when targeting non-motor symptoms in Parkinson's disease.
期刊介绍：
Frontiers in Aging Neuroscience is a leading journal in its field, publishing rigorously peer-reviewed research that advances our understanding of the mechanisms of Central Nervous System aging and age-related neural diseases. Specialty Chief Editor Thomas Wisniewski at the New York University School of Medicine is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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