Repetitive transcranial magnetic stimulation for motor function in stroke: a systematic review and meta-analysis of randomized controlled studies
Abstract
Objective: This study aimed to systematically evaluate the safety and effectiveness of repetitive transcranial magnetic stimulation (rTMS) in treating motor dysfunction in stroke patients.
Methods: A systematic search was conducted in five online databases, namely, Medline, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and SPORTDiscus, from their inception to July 29, 2024. Studies meeting the predetermined inclusion criteria were included. The data were analyzed using RevMan 5.4.1 software and Stata 15.0. The subgroup analysis was conducted based on various disease stages and intervention frequencies. The overall effects were estimated using either the fixed effects model or the random effects model, with standardized mean differences (SMDs). The level of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework.
Results: A total of 70 studies encompassing 2951 stroke survivors were included. The results of the quantitative analysis revealed that the application of 1 Hz rTMS over the contralesional primary motor cortex (M1) significantly improved motor function during both the early stage (2 = 47%, fixed-effect model) and recovery period (1-6 months) with moderate effect size (n = 233, SMD = 0.61, 95% CI 0.34 to 0.87, P 2 = 33%, fixed-effect model). In the context of activities of daily living (ADLs), the application of 1 Hz rTMS over the contralesional M1 can lead to improvements in…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 343 participants or records.
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