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

Published online by Cambridge University Press:  16 January 2015

HongCan Zhu
Affiliation:
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan, PR China
ZhaoMing Lu
Affiliation:
School of Pharmaceutical Sciences, Zhengzhou University, Henan, PR China
YiTing Jin
Affiliation:
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan, PR China
XiaoJia Duan
Affiliation:
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan, PR China
JunFang Teng
Affiliation:
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan, PR China
DongXiao Duan*
Affiliation:
Department of Physiology, Basic Medical College, Zhengzhou University, Henan, PR China
*
Associate Professor DongXiao Duan, Basic Medical College, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 45001, PR China.Tel: +86-371-67783111; Fax: +86-371-67783222; E-mail: [email protected]

Abstract

Objectives

Previous 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.

Methods

A 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.

Results

These 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.

Discussion

Low-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.

Type
Review Article
Copyright
© Scandinavian College of Neuropsychopharmacology 2015 

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References

1 Fahn, S. Description of Parkinson’s disease as a clinical syndrome. Ann NY Acad Sci 2003;991:114.CrossRefGoogle ScholarPubMed
2. Dorsey, ER, Constantinescu, R, Thompson, JP et al. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology 2007;68:384386.CrossRefGoogle ScholarPubMed
3. Rascol, O, Brooks, DJ, Korczyn, AD, Deyn, De, Clarke, CE, Lang, AE. A five-year study of the incidence of dyskinesia in patients with early Parkinson’s disease who were treated with ropinirole or levodopa. 056 Study Group. N Engl J Med 2000;342:14841491.CrossRefGoogle ScholarPubMed
4. Benninger, DH, Berman, BD, Houdayer, E et al. Intermittent theta-burst transcranial magnetic stimulation for treatment of Parkinson disease. Neurology 2011;76:601609.CrossRefGoogle ScholarPubMed
5. Zhu, C, Wang, G, Li, J et al. Adenosine A2A receptor antagonist istradefylline 20 versus 40 mg/day as augmentation for Parkinson’s disease: a meta-analysis. Neurol Res 2014;36:10281034.CrossRefGoogle ScholarPubMed
6. Dungo, R, Deeks, ED. Istradefylline: first global approval. Drugs 2013;73:875882.CrossRefGoogle ScholarPubMed
7. Chen, JJ, Liu, Z, Zhu, D et al. Bilateral vs. unilateral repetitive transcranial magnetic stimulation in treating major depression: a meta-analysis of randomized controlled trials. Psychiatry Res 2014;219:5157.CrossRefGoogle ScholarPubMed
8. Chen, JJ, Zhou, C, Wu, B et al. Left versus right repetitive transcranial magnetic stimulation in treating major depression: a meta-analysis of randomised controlled trials. Psychiatry Res 2013;210:12601264.CrossRefGoogle ScholarPubMed
9. Khedr, EM, Rothwell, JC, Shawky, OA, Ahmed, MA, Hamdy, A. Effect of daily repetitive transcranial magnetic stimulation on motor performance in Parkinson’s disease. Mov Disord 2006;21:22012205.CrossRefGoogle ScholarPubMed
10. Lomarev, MP, Kanchana, S, Bara-Jimenez, W, Iyer, M, Wassermann, EM, Hallett, M. Placebo-controlled study of rTMS for the treatment of Parkinson’s disease. Mov Disord 2006;21:325331.CrossRefGoogle ScholarPubMed
11. Elahi, B, Elahi, B, Chen, R. Effect of transcranial magnetic stimulation on Parkinson motor function: systematic review of controlled clinical trials. Mov Disord 2009;24:357363.CrossRefGoogle ScholarPubMed
12. Shirota, Y, Ohtsu, H, Hamada, M, Enomoto, H, Ugawa, Y. Research Committee on rTMS Treatment of Parkinson's Disease. Supplementary motor area stimulation for Parkinson disease: a randomized controlled study. Neurology 2013;80:14001405.CrossRefGoogle ScholarPubMed
13. Okabe, S, Ugawa, Y, Kanazawa, I. Effectiveness of rTMS on Parkinson’s Disease Study Group. 0.2-Hz repetitive transcranial magnetic stimulation has no add-on effects as compared to a realistic sham stimulation in Parkinson's disease. Mov Disord 2003;18:382388.CrossRefGoogle Scholar
14. Niu, X, Gou, Y. Observation of repetitively transcranial magnetic stimulation in the treatment of depression induced by Parkinson’s disease. Chinese Journal of Practical Nervous Disease 2012;15:1113.Google Scholar
15. Wang, M, Gu, P, Ma, X et al. Effects of low frequency repetitive transcranial magnetic stimulation on motor function and affective disorder in patients with Parkinson’s disease. Chin J Geriatr 2009;28:729732.Google Scholar
16. Hughes, AJ, Ben-Shlomo, Y, Daniel, SE, Lees, AJ. What features improve the accuracy of clinical diagnosis in Parkinson’s disease: a clinicopathologic study. Neurology 1992;42:11421146.CrossRefGoogle ScholarPubMed
17. Higgins, JPT, Altman, DG. Assessing risk of bias in included studies. In: Julian PT Higgins and Sally Green, editors. Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Collaboration, A John Wiley & Sons Ltd, 2011. p. 187243.CrossRefGoogle Scholar
18. Riley, RD, Higgins, JP, Deeks, JJ. Interpretation of random effects meta-analyses. BMJ 2011;342:d549.CrossRefGoogle ScholarPubMed
19. Higgins, JP, Thompson, SG, Deeks, JJ, Altman, DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557.CrossRefGoogle ScholarPubMed
20. Sacks, HS, Berrier, J, Reitman, D, Ancona-Berk, V, Chalmers, TC. Meta-analyses of randomized controlled trials. N Engl J Med 1987;316:450.CrossRefGoogle ScholarPubMed
21. Shimamoto, H, Takasaki, K, Shigemori, M, Imaizumi, T, Ayabe, M, Shoji, H. Therapeutic effect and mechanism of repetitive transcranial magnetic stimulation in Parkinson’s disease. J Neurol 2001;248(Suppl. 3):III48III52.CrossRefGoogle ScholarPubMed
22. Koch, G, Brusa, L, Caltagirone, C et al. rTMS of supplementary motor area modulates therapy-induced dyskinesias in Parkinson disease. Neurology 2005;65:623625.CrossRefGoogle ScholarPubMed
23. Zhang, H, Dai, Y, Su, M, Luo, W, , C. Clinical study of treating Parkinson disease by repetitive transcranial magnetic stimulation. J Clin Neulo 2005;18:266269.Google Scholar
24. Zhong, Y, Shimamoto, H, Shigemori, M. Repetitive transcranial magnetic stimulation in Parkinson’s disease. Mod J Neurd Neurosurg 2003;3:228230.Google Scholar
25. de Lau, LM, Breteler, MM. Epidemiology of Parkinson’s disease. Lancet Neurol 2006;5:525535.CrossRefGoogle ScholarPubMed
26. Xie, J, Chen, J, Wei, Q. Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: a meta-analysis of stimulus parameter effects. Neurol Res 2013;35:10841091.CrossRefGoogle ScholarPubMed
27. Fitzgerald, PB, Fountain, S, Daskalakis, ZJ. A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition. Clin Neurophysiol 2006;117:25842596.CrossRefGoogle ScholarPubMed
28. Eldaief, MC, Halko, MA, Buckner, RL, Pascual-Leone, A. Transcranial magnetic stimulation modulates the brain’s intrinsic activity in a frequency-dependent manner. Proc Natl Acad Sci USA 2011;108:2122921234.CrossRefGoogle Scholar
29. Wassermann, EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the Inter-national Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation. Electroencephalogr Clin Neurophysiol 1998;108:116.CrossRefGoogle Scholar
30. Chen, R, Gerloff, C, Classen, J, Wassermann, EM, Hallett, M, Cohen, LG. Safety of different inter-train intervals for repetitive transcranial magnetic stimulation and recommendations for safe ranges of stimulation parameters. Electroencephalogr Clin Neurophysiol 1997;105:415421.CrossRefGoogle ScholarPubMed
31. Schutter, D. Quantitative review of the efficacy of slow-frequency magnetic brain stimulation in major depressive disorder. Psychol Med 2010;40:1789.CrossRefGoogle ScholarPubMed
32. Eidelberg, D. Metabolic brain networks in neurodegener-ative disorders: a functional imaging approach. Trends Neurosci 2009;32:548557.CrossRefGoogle ScholarPubMed
33. Playford, ED, Jenkins, IH, Passingham, RE, Nutt, J, Frackowiak, RS, Brooks, DJ. Impaired mesial frontal and putamen activation in Parkinson’s disease: a positron emission tomography study. Ann Neurol 1992;32:151161.CrossRefGoogle ScholarPubMed
34. Sabatini, U, Boulanouar, K, Fabre, N et al. Cortical motor reorganization in akinetic patients with Parkinson’s disease: a functional MRI study. Brain 2000;123:394403.CrossRefGoogle ScholarPubMed
35. Wassermann, EM, Zimmermann, T. Transcranial magnetic brain stimulation: therapeutic promises and scientific gaps. Pharmacol Ther 2012;133:98107.CrossRefGoogle ScholarPubMed
36. Rosa, MA, Lisanby, SH. Somatic treatments for mood disorders. Neuropsychopharmacology 2012;37:102116.CrossRefGoogle ScholarPubMed
37. Schönfeldt-Lecuona, C, Lefaucheur, JP, Cardenas-Morales, L, Wolf, R, Kammer, T, Herwig, U. The value of neuronavigated rTMS for the treatment of depression. Neurophysiol Clin 2010;40:3743.CrossRefGoogle ScholarPubMed