Journal
BRAIN AND BEHAVIOR
Volume 12, Issue 8, Pages -Publisher
WILEY
DOI: 10.1002/brb3.2697
Keywords
cognitive dysfunction; freezing of gait; meta-analysis; Parkinson's disease; transcranial magnetic stimulation
Categories
Funding
- Guangxi Natural Science Foundation [2019GXNSFAA185029, 2019GXNSFDA185008]
- Medical Excellence Award
- Creative Research Development Grant from the First Affiliated Hospital of Guangxi Medical University [201907, 202101]
- Liuzhou Science and Technology Plan Project [2021CBC0121]
- Guangxi Zhuang Autonomous Region Health and Health Commission Self-financed Research Projects [Z20170891, Z20200017]
- National Natural Science Foundation of China [81860222, 81901394, 81960220, 82060226]
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This study found that repetitive transcranial magnetic stimulation (rTMS) has a positive effect on freezing of gait (FOG) and cognitive dysfunction in patients with Parkinson's disease (PD). However, the optimal rTMS protocol is still unknown and further high-quality studies are required.
Background Repetitive transcranial magnetic stimulation (rTMS) is acknowledged to be crucial to manage freezing of gait (FOG) and cognitive impairment for patients with Parkinson's disease (PD), but its effectiveness is unclear. Objective To determine the effects of rTMS on FOG and cognitive function in people with PD and to investigate potential factors that modulate the rTMS effects. Methods Databases searched included PubMed, Web of Science, EMBASE, and the Cochrane Library from inception to December 31, 2021. Eligible studies include a controlled randomized clinical trial of rTMS intervention for FOG and cognitive dysfunction in PD patients. The weighted mean difference (WMD) with 95% confidence intervals (CI) were calculated with fixed-effects models. The outcome of the study included gait and cognitive assessments. Results Sixteen studies with a total of 419 patients were included. Fixed-effects analysis revealed that rTMS was effective in improving freezing of gait questionnaire scores (short-term effect: WMD = -0.925, 95% CI: -1.642 to -0.209, p = .011; long-term effect: WMD = -2.120, 95% CI: -2.751 to -1.489, p = .000), 10-m walking time (short-term effect: WMD = -0.456, 95% CI: -0.793 to -0.119, p = .008; long-term effect: WMD = -0.526, 95% CI: -0.885 to -0.167, p = .004), Timed Up-and-Go scores (short-term effect: WMD = -1.064, 95% CI: -1.555 to -0.572, p = .000; long-term effect: WMD = -1.097, 95% CI: -1.422 to -0.772, p = .000), Montreal cognitive assessment (WMD = 3.714, 95% CI: 2.567 to 4.861, p = .000), and frontal assessment battery (WMD = -0.584, 95% CI: -0.934 to -0.234, p = .001). Conclusions RTMS showed a beneficial effect on FOG and cognitive dysfunction in parkinsonism. However, the optimal rTMS protocol has not been determined and further high-quality studies are needed.
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