» Articles » PMID: 36110393

Intermittent Theta-burst Stimulation with Physical Exercise Improves Poststroke Motor Function: A Systemic Review and Meta-analysis

Overview
Journal Front Neurol
Specialty Neurology
Date 2022 Sep 16
PMID 36110393
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Intermittent theta-burst stimulation (iTBS) is an optimized rTMS modality that could modulate the excitability of neural structures. Several studies have been conducted to investigate the efficacy of iTBS in improving the motor function of stroke patients. However, the specific role of iTBS in motor function recovery after stroke is unclear. Hence, in our study, we performed a meta-analysis to investigate the efficacy of iTBS for the motor function improvement of stroke patients.

Methods: MEDLINE, Embase, and Cochrane Library were searched until May 2022 for randomized controlled trials (RCTs).

Results: Thirteen RCTs with 334 patients were finally included in our study. The primary endpoints were the Fugl-Meyer assessment scale (FMA) and Motor Assessment Scale (MAS) change from baseline. We found that iTBS led to a significant reduction in FMA score ( = 0.002) but not in MAS score ( = 0.24) compared with the sham group. Moreover, standard 600-pulse stimulation showed a better effect on motor function improvement than the sham group ( = 0.004), however, 1200-pulse iTBS showed no effect on motor function improvement after stroke ( = 0.23). The effect of iTBS for improving motor function only exists in chronic stroke patients ( = 0.02) but not in subacute patients ( = 0.27).

Conclusion: This study supports that iTBS has good efficacy for improving motor function in stroke patients. Therefore, standard 600-pulse stimulation iTBS therapy is proper management and treatment for chronic stroke.

Citing Articles

The effectiveness of theta burst stimulation for motor recovery after stroke: a systematic review.

Fu Y, Wang C, Zhang L, Ji D, Xiang A, Qi J Eur J Med Res. 2024; 29(1):568.

PMID: 39609900 PMC: 11605871. DOI: 10.1186/s40001-024-02170-2.


Time dependent changes in protein expression induced by intermittent theta burst stimulation in a cell line.

Ismail F, Krishnan M, Jayaraj R, Bru-Mercier G, Pessia M, Ljubisavljevic M Front Neurol. 2024; 15:1396776.

PMID: 39529622 PMC: 11551774. DOI: 10.3389/fneur.2024.1396776.


Theta burst stimulation for enhancing upper extremity motor functions after stroke: a systematic review of clinical and mechanistic evidence.

Jiaqi Zhang J, Sui Y, Sack A, Bai Z, Kwong P, Sanchez Vidana D Rev Neurosci. 2024; 35(6):679-695.

PMID: 38671584 DOI: 10.1515/revneuro-2024-0030.


Theta burst stimulation: what role does it play in stroke rehabilitation? A systematic review of the existing evidence.

Jiang T, Wei X, Wang M, Xu J, Xia N, Lu M BMC Neurol. 2024; 24(1):52.

PMID: 38297193 PMC: 10832248. DOI: 10.1186/s12883-023-03492-0.


The effects of rTMS on motor recovery after stroke: a systematic review of fMRI studies.

Tang Z, Liu T, Han K, Liu Y, Su W, Wang R Neurol Sci. 2023; 45(3):897-909.

PMID: 37880452 DOI: 10.1007/s10072-023-07123-x.


References
1.
Hsu Y, Huang Y, Lin Y, Tang C, Liao K, Lee P . Intermittent theta burst stimulation over ipsilesional primary motor cortex of subacute ischemic stroke patients: a pilot study. Brain Stimul. 2012; 6(2):166-74. DOI: 10.1016/j.brs.2012.04.007. View

2.
Ziemann U, Siebner H . Modifying motor learning through gating and homeostatic metaplasticity. Brain Stimul. 2010; 1(1):60-6. DOI: 10.1016/j.brs.2007.08.003. View

3.
Krogh S, Jonsson A, Aagaard P, Kasch H . Efficacy of repetitive transcranial magnetic stimulation for improving lower limb function in individuals with neurological disorders: A systematic review and meta-analysis of randomized sham-controlled trials. J Rehabil Med. 2021; 54:jrm00256. PMC: 8862648. DOI: 10.2340/jrm.v53.1097. View

4.
Iyer N, Shaha A . Current concepts in the management of primary hyperparathyroidism. Indian J Surg Oncol. 2012; 1(2):112-9. PMC: 3421003. DOI: 10.1007/s13193-010-0023-9. View

5.
Li W, Wen Q, Xie Y, Hu A, Wu Q, Wang Y . Improvement of poststroke cognitive impairment by intermittent theta bursts: A double-blind randomized controlled trial. Brain Behav. 2022; 12(6):e2569. PMC: 9226849. DOI: 10.1002/brb3.2569. View