Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Language Recovery in Poststroke Survivors With Aphasia: An Updated Meta-analysis

2021 ◽  
pp. 154596832110112
Author(s):  
Zhongqiu Hong ◽  
Haiqing Zheng ◽  
Jing Luo ◽  
Mingyu Yin ◽  
Yinan Ai ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Treatment Effects ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Low Frequency ◽  
Language Function ◽  
Language Performance ◽  
Language Recovery ◽  
Subgroup Analyses

The effects of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) on treating poststroke aphasia (PSA) remain inconclusive. We aimed to evaluate the efficacy and safety of LF-rTMS on language function poststroke and determine potential factors that may affect treatment effects. Electronic databases, including MEDLINE, EMBASE, and Cochrane Library were searched to identify relevant randomized controlled trials (RCTs) concerning the effects of LF-rTMS on language performance poststroke. We adopted fixed- and random-effects models to estimate intervention effects, which were represented by the Hedges’ g and 95% CIs. Subgroup analyses regarding several factors potentially influencing the effects of LF-rTMS on language recovery were also conducted. A total of 14 RCTs involving 374 participants were included in the meta-analysis. The pooled analysis showed the positive and significant effects of LF-rTMS on language function, both short-term (Hedges’ g = 0.65; P < .05) and long-term (Hedges’ g = 0.46; P < .05). Subgroup analyses demonstrated that LF-rTMS for 20 minutes per day over 10 days yielded the largest effect size (Hedges’ g = 1.02; P < .05) and that LF-rTMS significantly improved language performance in the chronic stage after stroke (Hedges’ g = 0.55; P < .05). Patients with different native languages might have diverse responses to LF-rTMS treatment efficacy. Additionally, there were significant improvements in language subtests, including naming, repetition, comprehension, and writing. Overall, this updated meta-analysis demonstrated that LF-rTMS has significant positive effects on PSA, with moderate treatment effects. It provides additional evidence to support LF-rTMS as a promising complementary therapy to promote language recovery in PSA.

Effects of repetitive transcranial magnetic stimulation (rTMS) on aphasia in stroke patients: A systematic review and meta-analysis

2021 ◽  
pp. 026921552199955
Author(s):  
Jun Zhang ◽  
Dongling Zhong ◽  
Xili Xiao ◽  
Li Yuan ◽  
Yuxi Li ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Low Frequency ◽  
Risk Of Bias ◽  
Stroke Patients ◽  
Language Recovery ◽  
Better Than

Objective: To evaluate the effects and safety of repetitive transcranial magnetic stimulation (rTMS) on aphasia in stroke patients. Methods: We searched databases from inception to January 28, 2021. Randomized control trials investigating the effects and safety of rTMS for aphasia patients after stroke were included. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Review Manager 5.3 software. The quality of the evidence was assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Twenty-eight studies with 1287 patients were included. All studies were assessed at low or unclear risk of bias in one or more domains. The meta-analysis exhibited rTMS was better than sham rTMS and conventional rehabilitation in language recovery. Low-frequency rTMS showed greater improvement in language recovery except for comprehension than sham rTMS. Low-frequency and bilateral rTMS were superior to conventional rehabilitation in language recovery. High-frequency rTMS was no better than sham rTMS and conventional rehabilitation for improving aphasia. The rTMS had better effects in naming, comprehension and aphasia quotient at 20 sessions. Eleven studies reported rTMS was safe for aphasia patients after stroke. The quality of evidence for all outcomes was low or very low, and publication bias may exist. Conclusions: rTMS may be relatively effective and safe for aphasia patients after stroke. However, these findings should be treated with caution due to high heterogeneity and potential biases.

scholarly journals Low-Frequency Repetitive Transcranial Magnetic Stimulation for Stroke-Induced Upper Limb Motor Deficit: A Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Lan Zhang ◽  
Guoqiang Xing ◽  
Shiquan Shuai ◽  
Zhiwei Guo ◽  
Huaping Chen ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Upper Limb ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Low Frequency ◽  
Motor Evoked Potential ◽  
Motor Deficit ◽  
Resting Motor Threshold

Background and Purpose. This meta-analysis aimed to evaluate the therapeutic potential of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) over the contralesional hemisphere on upper limb motor recovery and cortex plasticity after stroke.Methods. Databases of PubMed, Medline, ScienceDirect, Cochrane, and Embase were searched for randomized controlled trials published before Jun 31, 2017. The effect size was evaluated by using the standardized mean difference (SMD) and a 95% confidence interval (CI). Resting motor threshold (rMT) and motor-evoked potential (MEP) were also examined.Results. Twenty-two studies of 1 Hz LF-rTMS over the contralesional hemisphere were included. Significant efficacy was found on finger flexibility (SMD = 0.75), hand strength (SMD = 0.49), and activity dexterity (SMD = 0.32), but not on body function (SMD = 0.29). The positive changes of rMT (SMD = 0.38 for the affected hemisphere and SMD = −0.83 for the unaffected hemisphere) and MEP (SMD = −1.00 for the affected hemisphere and SMD = 0.57 for the unaffected hemisphere) were also significant.Conclusions. LF-rTMS as an add-on therapy significantly improved upper limb functional recovery especially the hand after stroke, probably through rebalanced cortical excitability of both hemispheres. Future studies should determine if LF-rTMS alone or in conjunction with practice/training would be more effective.Clinical Trial Registration Information. This trial is registered with unique identifierCRD42016042181.

Low-frequency repetitive transcranial magnetic stimulation on Parkinson motor function: a meta-analysis of randomised controlled trials

2015 ◽  
Vol 27 (2) ◽  
pp. 82-89 ◽  
Author(s):  
HongCan Zhu ◽  
ZhaoMing Lu ◽  
YiTing Jin ◽  
XiaoJia Duan ◽  
JunFang Teng ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Randomised Controlled Trials ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Low Frequency ◽  
Controlled Trials ◽  
Randomised Controlled ◽  
Low Frequency Rtms ◽  
Updrs Part

ObjectivesPrevious 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.MethodsA 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.ResultsThese 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.DiscussionLow-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.

Low-Frequency Repetitive Transcranial Magnetic Stimulation in Patients With Poststroke Aphasia: Systematic Review and Meta-Analysis of Its Effect Upon Communication

2020 ◽  
Vol 63 (11) ◽  
pp. 3801-3815
Author(s):  
Liqun Yao ◽  
Hongjia Zhao ◽  
Cuiling Shen ◽  
Fang Liu ◽  
Li Qiu ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Low Frequency ◽  
Language Ability ◽  
Controlled Trials ◽  
Functional Communication ◽  
Language Performance ◽  
Randomized Controlled

Objective The aim of the study was to investigate the effectiveness and safety of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) in patients with poststroke aphasia. Method We comprehensively searched for eligible studies from 11 electronic medical databases from their inception to February 20, 2019. Randomized controlled trials reporting the effectiveness of LF-rTMS for patients with poststroke aphasia were included. The primary outcome was language ability. The secondary outcomes were functional communication and adverse events. The methodological quality of the randomized controlled trials was evaluated by the Cochrane Back Review Group Risk of Bias Assessment Criteria. Results Of the 567 records retrieved, 18 studies with a total of 536 participants were included. All the included studies were of relatively acceptable methodological quality. All studies but one used LF-rTMS + speech and language therapy (SLT), not LF-rTMS alone. The meta-analysis showed that LF-rTMS had beneficial effects for patients with aphasia after a stroke in terms of naming, repetition, comprehension, written language, and functional communication. The subgroup analyses of language performance showed positive effects of LF-rTMS among stroke patients with chronic aphasia and acute aphasia. LF-rTMS + SLT had effects on language performance that were superior to the sham rTMS + SLT and SLT alone. A shorter LF-rTMS duration benefited language performance more than a longer duration. Additionally, 20 min of LF-rTMS per session produced a positive effect on language ability for patients with aphasia after a stroke. No adverse events were reported. Conclusions LF-rTMS + SLT is an effective and safe method for patients with poststroke aphasia to improve their language performance. Additionally, the most commonly used LF-rTMS protocol for patients with aphasia after a stroke was 90% of the resting motor threshold 20 min per day, 5 days per week, for 2 weeks.

scholarly journals The effects of repetitive transcranial magnetic stimulation on empathy: a systematic review and meta-analysis

2017 ◽  
Vol 48 (5) ◽  
pp. 737-750 ◽  
Author(s):  
C.-C. Yang ◽  
N. Khalifa ◽  
B. Völlm
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Therapeutic Interventions ◽  
Effect Sizes ◽  
Cochrane Library ◽  
Subgroup Analyses ◽  
Meta Analyses ◽  
Clinical Populations

Empathy is a multi-dimensional concept with affective and cognitive components, the latter often referred to as Theory of Mind (ToM). Impaired empathy is prevalent in people with neuropsychiatric disorders, such as personality disorder, psychopathy, and schizophrenia, highlighting the need to develop therapeutic interventions to address this. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive therapeutic technique that has been effective in treating various neuropsychiatric conditions, can be potentially used to modulate empathy. To our knowledge, no systematic reviews or meta-analyses in this field have been conducted. The aim of the current study was to review the literature on the use of rTMS to modulate empathy in adults. Seven electronic databases (AMED, Cochrane library, EMBASE, Medline, Pubmed, PsycInfo, and Web of Science) were searched using appropriate search terms. Twenty-two studies were identified, all bar one study involved interventions in healthy rather than clinical populations, and 18 of them, providing results for 24 trials, were included in the meta-analyses. Results showed an overall small, but statistically significant, effect in favour of active rTMS in healthy individuals. Differential effects across cognitive and affective ToM were evident. Subgroup analyses for cognitive ToM revealed significant effect sizes on excitatory rTMS, offline paradigms, and non-randomised design trials. Subgroup analyses for affective ToM revealed significant effect sizes on excitatory rTMS, offline paradigms, and non-randomised design trials. Meta-regression revealed no significant sources of heterogeneity. In conclusion, rTMS may have discernible effects on different components of empathy. Further research is required to examine the effects of rTMS on empathy in clinical and non-clinical populations, using appropriate empathy tasks and rTMS protocols.

Antiepileptic effects of low frequency repetitive transcranial magnetic stimulation: A meta-analysis

2011 ◽  
Vol 96 (3) ◽  
pp. 231-240 ◽  
Author(s):  
Wan-Yu Hsu ◽  
Chia-Hsiung Cheng ◽  
Ming-Wei Lin ◽  
Yang-Hsin Shih ◽  
Kwong-Kum Liao ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Low Frequency

scholarly journals The Effect of Repetitive Transcranial Magnetic Stimulation on Dysphagia After Stroke: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 15 ◽  
Author(s):  
Weiwei Yang ◽  
Xiongbin Cao ◽  
Xiaoyun Zhang ◽  
Xuebing Wang ◽  
Xiaowen Li ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Subgroup Analysis ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Low Frequency ◽  
Training Group ◽  
Cochrane Library ◽  
Significant Difference ◽  
The Cochrane Library

Objective: The primary purpose of our study is to systemically evaluate the effect of repetitive transcranial magnetic stimulation (rTMS) on recovery of dysphagia after stroke.Search Methods: We searched randomized controlled trials (RCTs) and non-RCTs published by PubMed, the Cochrane Library, ScienceDirect, MEDLINE, and Web of Science from inception until April 24, 2021. Language is limited to English. After screening and extracting the data, and evaluating the quality of the selected literature, we carried out the meta-analysis with software RevMan 5.3 and summarized available evidence from non-RCTs.Results: Among 205 potentially relevant articles, 189 participants (from 10 RCTs) were recruited in the meta-analysis, and six non-RCTs were qualitatively described. The random-effects model analysis revealed a pooled effect size of SMD = 0.65 (95% CI = 0.04–1.26, p = 0.04), which indicated that rTMS therapy has a better effect than conventional therapy. However, the subgroup analysis showed that there was no significant difference between low-frequency and high-frequency groups. Even more surprisingly, there were no statistically significant differences between the two groups and the conventional training group in the subgroup analysis, but the combined effect was positive.Conclusion: Our study suggests that rTMS might be effective in treating patients with dysphagia after stroke.

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