{"title":"低频重复经颅磁刺激对帕金森运动功能的影响:随机对照试验的荟萃分析。","authors":"HongCan Zhu, ZhaoMing Lu, YiTing Jin, XiaoJia Duan, JunFang Teng, DongXiao Duan","doi":"10.1017/neu.2014.43","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Previous studies have demonstrated inconsistent findings regarding the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) in treating motor symptoms of Parkinson's disease (PD). Therefore, this meta-analysis was conducted to assess the efficacy of low-frequency rTMS.</p><p><strong>Methods: </strong>A comprehensive literature search (including PubMed, CCTR, Embase, Web of Science, CNKI, CBM-disc, NTIS,EAGLE, Clinical Trials, Current Controlled Trials, International Clinical Trials Registry) was conducted dating until June 2014. The key search terms ('Parkinson', 'PD', 'transcranial magnetic stimulation', 'TMS', 'RTMS' and 'noninvasive brain stimulation') produced eight high-quality randomised controlled trials (RCT) of low-frequency rTMS versus sham stimulation.</p><p><strong>Results: </strong>These eight studies, composed of 319 patients, were meta-analysed through assessment of the decreased Unified Parkinson's Disease Rating Scale (UPDRS part III) score. Pooling of the results from these RCTs yielded an effect size of -0.40 (95%CI=-0.73 to -0.06, p<0.05) in UPDRS part III, which indicated that low-frequency rTMS could have 5.05 (95%CI=-1.73 to -8.37) point decrease in UPDRS part III score than sham stimulation.</p><p><strong>Discussion: </strong>Low-frequency rTMS had a significant effect on motor signs in PD. 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引用次数: 32
摘要
目的:以往的研究表明低频重复经颅磁刺激(rTMS)治疗帕金森病(PD)运动症状的疗效不一致。因此,本荟萃分析旨在评估低频rTMS的疗效。方法:检索截至2014年6月的综合文献(包括PubMed、CCTR、Embase、Web of Science、CNKI、CBM-disc、NTIS、EAGLE、Clinical Trials、Current Controlled Trials、International Clinical Trials Registry)。关键搜索词(“帕金森”,“PD”,“经颅磁刺激”,“经颅磁刺激”,“RTMS”和“无创脑刺激”)产生了8个高质量的低频RTMS与假刺激的随机对照试验(RCT)。结果:这8项研究,包括319名患者,通过降低统一帕金森病评定量表(UPDRS part III)评分进行meta分析。将这些随机对照试验的结果汇总后得出的效应值为-0.40 (95%CI=-0.73至-0.06)。讨论:低频rTMS对PD患者的运动体征有显著影响。由于本研究纳入的rct和PD患者数量有限,需要进一步的大规模多中心rct来验证我们的结论。
Low-frequency repetitive transcranial magnetic stimulation on Parkinson motor function: a meta-analysis of randomised controlled trials.
Objectives: Previous studies have demonstrated inconsistent findings regarding the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) in treating motor symptoms of Parkinson's disease (PD). Therefore, this meta-analysis was conducted to assess the efficacy of low-frequency rTMS.
Methods: A comprehensive literature search (including PubMed, CCTR, Embase, Web of Science, CNKI, CBM-disc, NTIS,EAGLE, Clinical Trials, Current Controlled Trials, International Clinical Trials Registry) was conducted dating until June 2014. The key search terms ('Parkinson', 'PD', 'transcranial magnetic stimulation', 'TMS', 'RTMS' and 'noninvasive brain stimulation') produced eight high-quality randomised controlled trials (RCT) of low-frequency rTMS versus sham stimulation.
Results: These eight studies, composed of 319 patients, were meta-analysed through assessment of the decreased Unified Parkinson's Disease Rating Scale (UPDRS part III) score. Pooling of the results from these RCTs yielded an effect size of -0.40 (95%CI=-0.73 to -0.06, p<0.05) in UPDRS part III, which indicated that low-frequency rTMS could have 5.05 (95%CI=-1.73 to -8.37) point decrease in UPDRS part III score than sham stimulation.
Discussion: Low-frequency rTMS had a significant effect on motor signs in PD. As the number of RCTs and PD patients included here was limited, further large-scale multi-center RCTs were required to validate our conclusions.
期刊介绍:
Acta Neuropsychiatrica is an international journal focussing on translational neuropsychiatry. It publishes high-quality original research papers and reviews. The Journal''s scope specifically highlights the pathway from discovery to clinical applications, healthcare and global health that can be viewed broadly as the spectrum of work that marks the pathway from discovery to global health.