Effect of different modalities of transcranial magnetic stimulation on Parkinson’s patients cognitive impairment and long-term effectiveness: a systematic review and network meta-analysis

Yang, Y.; Yan, Z.; Chang, W.; Ding, J.; Xu, H.

Abstract:

Objective: This study used network Meta-analysis to compare the effects of different transcranial magnetic stimulation (TMS) modalities on the effectiveness and long-term validity of improving cognitive function in Parkinson’s patients. Methods: Computer searches of the Cochrane Library, PubMed, Web of Science, Embass, CNKI and Wanfang Data were conducted to collect randomized controlled clinical studies on TMS to improve cognitive function in Parkinson’s patients published from the time of library construction to December 2023. Results: A total of 22 studies and 1,473 patients were included, comprising 5 interventions: high frequency repetitive transcranial magnetic stimulation (HF-rTMS), low frequency repetitive transcranial magnetic stimulation (LF-rTMS), intermittent theta burst stimulation (iTBS), sham stimulation and conventional rehabilitation therapy (CRT). Network Meta-analysis showed that the ranking results of different TMS intervention modalities in terms of MoCA scores were: HF-rTMS > LF-rTMS > iTBS > sham > CRT, the ranking results of different TMS intervention modalities in terms of MMSE scores were: HF-rTMS > LF-rTMS > sham > CRT. The effect of TMS on improving Parkinsonian cognitive function lasted for 1 month compared to the no-stimulation group. Conclusion: TMS has some long-term sustained effects on improving cognitive function in Parkinson’s patients. HF-rTMS is more effective in improving cognitive function in Parkinson’s patients.

Patologie/Applicazioni:

• Riabilitazione cognitiva
• Stimolazione Magnetica Transcranica (TMS)
• Parkinson

Anno:

2024

Tipo di pubblicazione:

Articolo

Testata scientifica:

Frontiers

Mese:

03

Nota:

In questa meta-analisi sono stati valutati diversi metodi di stimolazione rispetto alla riabilitazione convenzionale per migliorare la disfunzione cognitiva nei pazienti affetti da malattia di Parkinson (High-Frequency rTMS, Low-Frequency rTMS e stimolazione con Theta Burst). La ricerca ha incluso 22 studi clinici randomizzati con un totale di 1.473 pazienti. I risultati principali indicano che l'HF-rTMS ha migliorato significativamente i punteggi MoCA (Montreal Cognitive Assessment) e MMSE (Mini-Mental State Examination), mentre la LF-rTMS ha migliorato significativamente i punteggi MMSE. Questo suggerisce che l'HF-rTMS potrebbe essere più efficace nel migliorare la funzione cognitiva. I miglioramenti ottenuti con HF-rTMS e LF-rTMS si sono mantenuti statsisticamente rilevanti per almeno un mese dal termine del trattamento. In conclusione, l'HF-rTMS della DLPFC sembra essere il metodo più efficace nel migliorare i deficit cognitivi nei pazienti con malattia di Parkinson.

DOI:

10.3389/fnins.2024.1354864