Efficacy of repetitive transcranial magnetic stimulation and transcranial direct current stimulation in focal hand dystonia: Systematic review of intervention trials

Abstract

We reviewed trials examining the efficacy of repetitive transcranial magnetic stimulation (rTMS) (seven trials) and transcranial direct current stimulation (tDCS) (seven trials) in focal and dystonia (FHD). Among tDCS trials, one randomized controlled trial and three quasi-experimental studies showed evidence of efficacy; these trials combined different types of stimulations or used tDCS along with neurorehabilitation. Four rTMS trials showed evidence of efficacy but differed in stimulation parameters. Risk of bias was noted in nearly all the trials. There is weak and inconsistent evidence for the efficacy of rTMS and tDCS administered alone or with other interventions in FHD.

Keywords: Brain stimulation; Clinical trials; Musician’s cramp; Repetitive transcranial magnetic stimulation; Transcranial direct current stimulation; Writer’s cramp.