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Meta-Analysis
. 2017 Nov 1;7(1):14840.
doi: 10.1038/s41598-017-13260-z.

Using Non-Invasive Transcranial Stimulation to Improve Motor and Cognitive Function in Parkinson's Disease: A Systematic Review and Meta-Analysis

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Free PMC article
Meta-Analysis

Using Non-Invasive Transcranial Stimulation to Improve Motor and Cognitive Function in Parkinson's Disease: A Systematic Review and Meta-Analysis

Alicia M Goodwill et al. Sci Rep. .
Free PMC article

Abstract

Parkinson's disease (PD) is a neurodegenerative disorder affecting motor and cognitive abilities. There is no cure for PD, therefore identifying safe therapies to alleviate symptoms remains a priority. This meta-analysis quantified the effectiveness of repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (TES) to improve motor and cognitive dysfunction in PD. PubMed, EMBASE, Web of Science, Google Scholar, Scopus, Library of Congress and Cochrane library were searched. 24 rTMS and 9 TES studies (n = 33) with a sham control group were included for analyses. The Physiotherapy Evidence Database and Cochrane Risk of Bias showed high quality (7.5/10) and low bias with included studies respectively. Our results showed an overall positive effect in favour of rTMS (SMD = 0.394, CI [0.106-0.683], p = 0.007) and TES (SMD = 0.611, CI [0.188-1.035], p = 0.005) compared with sham stimulation on motor function, with no significant differences detected between rTMS and TES (Q [1] = 0.69, p = 0.406). Neither rTMS nor TES improved cognition. No effects for stimulation parameters on motor or cognitive function were observed. To enhance the clinical utility of non-invasive brain stimulation (NBS), individual prescription of stimulation parameters based upon symptomology and resting excitability state should be a priority of future research.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram of study inclusion for this systematic review and meta-analysis.
Figure 2
Figure 2
Forrest plot of studies using rTMS to improve motor function.
Figure 3.
Figure 3.
Forrest plot of overall effects of rTMS on cognitive function.
Figure 4
Figure 4
Forrest plot of overall effects of TES on (A) motor and (B) cognitive function.
Figure 5
Figure 5
Funnel plot indicating the level of publication bias of all studies included in the meta-analysis.(A) rTMS motor and (B) rTMS cognitive function; (C) TES motor and (D) TES cognitive function.

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