Low-Frequency Repetitive Transcranial Magnetic Stimulation for Stroke-Induced Upper Limb Motor Deficit: A Meta-Analysis
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, Sc...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-01-01
|
| Series: | Neural Plasticity |
| Online Access: | http://dx.doi.org/10.1155/2017/2758097 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832556652895666176 |
|---|---|
| author | Lan Zhang Guoqiang Xing Shiquan Shuai Zhiwei Guo Huaping Chen Morgan A. McClure Xiaojuan Chen Qiwen Mu |
| author_facet | Lan Zhang Guoqiang Xing Shiquan Shuai Zhiwei Guo Huaping Chen Morgan A. McClure Xiaojuan Chen Qiwen Mu |
| author_sort | Lan Zhang |
| collection | DOAJ |
| description | 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 identifier CRD42016042181. |
| format | Article |
| id | doaj-art-fecbdbe627c44259b29cf4650e8f530e |
| institution | Kabale University |
| issn | 2090-5904 1687-5443 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Neural Plasticity |
| spelling | doaj-art-fecbdbe627c44259b29cf4650e8f530e2025-02-03T05:44:52ZengWileyNeural Plasticity2090-59041687-54432017-01-01201710.1155/2017/27580972758097Low-Frequency Repetitive Transcranial Magnetic Stimulation for Stroke-Induced Upper Limb Motor Deficit: A Meta-AnalysisLan Zhang0Guoqiang Xing1Shiquan Shuai2Zhiwei Guo3Huaping Chen4Morgan A. McClure5Xiaojuan Chen6Qiwen Mu7Department of Imaging & Imaging Institute of Rehabilitation and Development of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong 637000, ChinaDepartment of Imaging & Imaging Institute of Rehabilitation and Development of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong 637000, ChinaDepartment of Imaging & Imaging Institute of Rehabilitation and Development of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong 637000, ChinaDepartment of Imaging & Imaging Institute of Rehabilitation and Development of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong 637000, ChinaDepartment of Imaging & Imaging Institute of Rehabilitation and Development of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong 637000, ChinaDepartment of Imaging & Imaging Institute of Rehabilitation and Development of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong 637000, ChinaNorth Sichuan Medical College, Nanchong 637000, ChinaDepartment of Imaging & Imaging Institute of Rehabilitation and Development of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong 637000, ChinaBackground 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 identifier CRD42016042181.http://dx.doi.org/10.1155/2017/2758097 |
| spellingShingle | Lan Zhang Guoqiang Xing Shiquan Shuai Zhiwei Guo Huaping Chen Morgan A. McClure Xiaojuan Chen Qiwen Mu Low-Frequency Repetitive Transcranial Magnetic Stimulation for Stroke-Induced Upper Limb Motor Deficit: A Meta-Analysis Neural Plasticity |
| title | Low-Frequency Repetitive Transcranial Magnetic Stimulation for Stroke-Induced Upper Limb Motor Deficit: A Meta-Analysis |
| title_full | Low-Frequency Repetitive Transcranial Magnetic Stimulation for Stroke-Induced Upper Limb Motor Deficit: A Meta-Analysis |
| title_fullStr | Low-Frequency Repetitive Transcranial Magnetic Stimulation for Stroke-Induced Upper Limb Motor Deficit: A Meta-Analysis |
| title_full_unstemmed | Low-Frequency Repetitive Transcranial Magnetic Stimulation for Stroke-Induced Upper Limb Motor Deficit: A Meta-Analysis |
| title_short | Low-Frequency Repetitive Transcranial Magnetic Stimulation for Stroke-Induced Upper Limb Motor Deficit: A Meta-Analysis |
| title_sort | low frequency repetitive transcranial magnetic stimulation for stroke induced upper limb motor deficit a meta analysis |
| url | http://dx.doi.org/10.1155/2017/2758097 |
| work_keys_str_mv | AT lanzhang lowfrequencyrepetitivetranscranialmagneticstimulationforstrokeinducedupperlimbmotordeficitametaanalysis AT guoqiangxing lowfrequencyrepetitivetranscranialmagneticstimulationforstrokeinducedupperlimbmotordeficitametaanalysis AT shiquanshuai lowfrequencyrepetitivetranscranialmagneticstimulationforstrokeinducedupperlimbmotordeficitametaanalysis AT zhiweiguo lowfrequencyrepetitivetranscranialmagneticstimulationforstrokeinducedupperlimbmotordeficitametaanalysis AT huapingchen lowfrequencyrepetitivetranscranialmagneticstimulationforstrokeinducedupperlimbmotordeficitametaanalysis AT morganamcclure lowfrequencyrepetitivetranscranialmagneticstimulationforstrokeinducedupperlimbmotordeficitametaanalysis AT xiaojuanchen lowfrequencyrepetitivetranscranialmagneticstimulationforstrokeinducedupperlimbmotordeficitametaanalysis AT qiwenmu lowfrequencyrepetitivetranscranialmagneticstimulationforstrokeinducedupperlimbmotordeficitametaanalysis |