Clinical effects of repetitive transcranial magnetic stimulation therapy on Parkinson's disease: a Meta-analysis

Abstract

Objective To investigate the clinical effect of repetitive transcranial magnetic stimulation (rTMS) therapy on Parkinson's disease (PD) using Meta-analysis. Methods Taking transcranial magnetic stimulation or TMS, Parkinson's disease or PD and randomized controlled trial as retrival words, search related articles during 1999 to 2013 from databases such as PubMed, EMBASE, Ovid MEDLINE, VIP, Wanfang and China National Knowledge Intrastructure (CNKI). Finally 16 articles (4 in Chinese and 12 in English) were included for Meta-analysis according to high-frequency stimulation (HFS > 1 Hz) and low-frequency stimulation (LFS ≤ 1 Hz) respectively.  Results A total pf 455 PD patients were enrolled and divided into TMS group (N = 236) and control group (N = 219). After HFS and LFS therapies, the Unified Parkinson's Disease Rating Scale (UPDRS) score in TMS group was significantly different from control group (WMD = -5.010, 95%CI: -7.370— -2.650, P = 0.000; WMD = -6.140, 95%CI: -8.750— -3.530, P = 0.000). After HFS therapy, the UPDRS Ⅲ motor (WMD = -4.380, 95%CI: -8.260— -0.500; P = 0.003) and activities of daily living (ADL) scores (WMD = -3.740, 95%CI: -4.660— -2.820; P = 0.000) in TMS group were significantly different from that in control group. There were no significant differences in UPDRS Ⅲ motor score with LFS therapy (WMD = -2.160, 95%CI: -5.010— -0.690; P = 0.370) and the Mini-Mental State Examination (MMSE) score with HFS therapy between 2 groups (WMD = 0.260, 95%CI: -0.660—1.180; P = 0.580).  Conclusions Repetitive transcranial magnetic stimulation therapy can ameliorate partial symptoms of Parkinson's disease for enhancing the quality of life, however, the improvement for mental disability was not found.

DOI: 10.3969/j.issn.1672-6731.2015.04.010