Unveiling the Efficacy of Repetitive Transcranial Magnetic Stimulation in Parkinson's Disease: A Comprehensive Review of Systematic Analyses

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2025 Jan 6

PMID 39761282

Authors

Lingwen Zhang

Yanhong Jiang

Wenhui Fan

Hua Xue

Affiliations

Soon will be listed here.

Abstract

Background: Many systematic reviews (SRs) have reported the repetitive transcranial magnetic stimulation (rTMS) for Parkinson' s disease (PD), but the quality of the evidence is unclear. The aim of this study was to summarize the evidence provided by SRs on the effect of rTMS on PD.

Methods: A comprehensive search for SRs published from the establishment of the library to March 1, 2024, was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, VIP and Wanfang databases. The A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), the Risk of Bias for Systematic Reviews (ROBIS), and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool were used to evaluate the methodology quality, risk of bias and evidence quality of SRs, respectively.

Results: We identified 16 SRs. According to the results of the AMSTAR-2, 12.5% (2/16) of the SRs rated as high quality, 43.75% (7/16) rated as low quality, and 43.75% (7/16) rated as very low quality. Based on the ROBIS tool, 6 (37.5%) SRs had low risk of bias. The GRADE results suggested that 16.13% (10/62) of the evidence was of moderate quality, 33.87% (21/62) of the evidence was of low quality and 50% (31/62) of the evidence was of very low quality. Moderate-quality results show that rTMS can improve PD motor symptoms.

Conclusions: Here we show that rTMS can improve the motor symptoms of PD, but its effectiveness in treating non-motor symptoms of PD is inconsistent. Due to the methodological limitations and diversity in study designs, future studies should focus on addressing these issues by providing thorough methodological details, standardizing rTMS protocols, evaluating side effects, and comparing with other treatments.

References

Yang C, Guo Z, Peng H, Xing G, Chen H, McClure M . Repetitive transcranial magnetic stimulation therapy for motor recovery in Parkinson's disease: A Meta-analysis. Brain Behav. 2018; 8(11):e01132. PMC: 6236247. DOI: 10.1002/brb3.1132. View

Malenka R, Bear M . LTP and LTD: an embarrassment of riches. Neuron. 2004; 44(1):5-21. DOI: 10.1016/j.neuron.2004.09.012. View

Tanaka M, Vecsei L . Revolutionizing our understanding of Parkinson's disease: Dr. Heinz Reichmann's pioneering research and future research direction. J Neural Transm (Vienna). 2024; 131(12):1367-1387. PMC: 11608389. DOI: 10.1007/s00702-024-02812-z. View

Pascual-Leone A, Valls-Sole J, Brasil-Neto J, Cammarota A, Grafman J, Hallett M . Akinesia in Parkinson's disease. II. Effects of subthreshold repetitive transcranial motor cortex stimulation. Neurology. 1994; 44(5):892-8. DOI: 10.1212/wnl.44.5.892. View

Xie Y, Gao Q, He C, Bian R . Effect of Repetitive Transcranial Magnetic Stimulation on Gait and Freezing of Gait in Parkinson Disease: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2019; 101(1):130-140. DOI: 10.1016/j.apmr.2019.07.013. View

Li R, He Y, Qin W, Zhang Z, Su J, Guan Q . Effects of Repetitive Transcranial Magnetic Stimulation on Motor Symptoms in Parkinson's Disease: A Meta-Analysis. Neurorehabil Neural Repair. 2022; 36(7):395-404. DOI: 10.1177/15459683221095034. View

Gaynor L, Kuhn A, Dileone M, Litvak V, Eusebio A, Pogosyan A . Suppression of beta oscillations in the subthalamic nucleus following cortical stimulation in humans. Eur J Neurosci. 2008; 28(8):1686-95. PMC: 2695156. DOI: 10.1111/j.1460-9568.2008.06363.x. View

Rektorova I, Anderkova L . Noninvasive Brain Stimulation and Implications for Nonmotor Symptoms in Parkinson's Disease. Int Rev Neurobiol. 2017; 134:1091-1110. DOI: 10.1016/bs.irn.2017.05.009. View

Shea B, Reeves B, Wells G, Thuku M, Hamel C, Moran J . AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017; 358:j4008. PMC: 5833365. DOI: 10.1136/bmj.j4008. View

10.

Latorre A, Rocchi L, Berardelli A, Bhatia K, Rothwell J . The use of transcranial magnetic stimulation as a treatment for movement disorders: A critical review. Mov Disord. 2019; 34(6):769-782. DOI: 10.1002/mds.27705. View

11.

Lench D, DeVries W, Kearney-Ramos T, Chesnutt A, Monsch E, Embry A . Paired inhibitory stimulation and gait training modulates supplemental motor area connectivity in freezing of gait. Parkinsonism Relat Disord. 2021; 88:28-33. PMC: 8485722. DOI: 10.1016/j.parkreldis.2021.05.028. View

12.

Goodwill A, Lum J, Hendy A, Muthalib M, Johnson L, Albein-Urios N . Using non-invasive transcranial stimulation to improve motor and cognitive function in Parkinson's disease: a systematic review and meta-analysis. Sci Rep. 2017; 7(1):14840. PMC: 5665996. DOI: 10.1038/s41598-017-13260-z. View

13.

Cambiaghi M, Infortuna C, Gualano F, Elsamadisi A, Malik W, Buffelli M . High-frequency rTMS modulates emotional behaviors and structural plasticity in layers II/III and V of the mPFC. Front Cell Neurosci. 2022; 16:1082211. PMC: 9792489. DOI: 10.3389/fncel.2022.1082211. View

14.

Salinas F, Lancaster J, Fox P . Detailed 3D models of the induced electric field of transcranial magnetic stimulation coils. Phys Med Biol. 2007; 52(10):2879-92. DOI: 10.1088/0031-9155/52/10/016. View

15.

Strafella A, Paus T, Fraraccio M, Dagher A . Striatal dopamine release induced by repetitive transcranial magnetic stimulation of the human motor cortex. Brain. 2003; 126(Pt 12):2609-15. DOI: 10.1093/brain/awg268. View

16.

Chervyakov A, Chernyavsky A, Sinitsyn D, Piradov M . Possible Mechanisms Underlying the Therapeutic Effects of Transcranial Magnetic Stimulation. Front Hum Neurosci. 2015; 9:303. PMC: 4468834. DOI: 10.3389/fnhum.2015.00303. View

17.

Valipoor S, Ahrentzen S, Srinivasan R, Akiely F, Gopinadhan J, Okun M . The use of virtual reality to modify and personalize interior home features in Parkinson's disease. Exp Gerontol. 2022; 159:111702. DOI: 10.1016/j.exger.2022.111702. View

18.

Chung C, Mak M, Hallett M . Transcranial Magnetic Stimulation Promotes Gait Training in Parkinson Disease. Ann Neurol. 2020; 88(5):933-945. PMC: 8470277. DOI: 10.1002/ana.25881. View

19.

Makkos A, Pal E, Aschermann Z, Janszky J, Balazs E, Takacs K . High-Frequency Repetitive Transcranial Magnetic Stimulation Can Improve Depression in Parkinson's Disease: A Randomized, Double-Blind, Placebo-Controlled Study. Neuropsychobiology. 2016; 73(3):169-77. DOI: 10.1159/000445296. View

20.

Xiang S, Zhou Y, Fu J, Zhang T . rTMS pre-treatment effectively protects against cognitive and synaptic plasticity impairments induced by simulated microgravity in mice. Behav Brain Res. 2018; 359:639-647. DOI: 10.1016/j.bbr.2018.10.001. View