Article

The aim of this study was to evaluate the short- and long-term effects
as well as other parameters of repetitive transcranial magnetic stimulation
(rTMS) on upper limb motor functional recovery after stroke. DATA SOURCES: The
databases of PubMed, Medline, Science Direct, Cochrane,
and Embase were searched
for randomized controlled studies reporting effects of rTMS on upper limb motor
recovery published before October 30, 2016. REVIEW METHODS: The short- and
long-term mean effect sizes as well as the effect size of rTMS frequency of
pulse, post-stroke onset, and theta burst stimulation patterns were summarized by
calculating the standardized mean difference (SMD) and the 95% confidence
interval using fixed/random effect models as appropriate. RESULTS: Thirty-four
studies with 904 participants were included in this systematic review. Pooled
estimates show that rTMS significantly improved short-term (SMD, 0.43; P < 0.001)
and long-term (SMD, 0.49;
P < 0.001) manual dexterity.
More pronounced effects
were found for rTMS administered in the acute phase of stroke (SMD, 0.69),
subcortical stroke (SMD, 0.66), 5-session rTMS treatment (SMD, 0.67) and
intermittent theta burst stimulation (SMD, 0.60). Only three studies reported
mild adverse events such as headache and increased anxiety . CONCLUSIONS:
Five-session rTMS treatment could best improve stroke-induced upper limb
dyskinesia acutely and in a long-lasting manner. Intermittent theta burst
stimulation is more beneficial than continuous theta burst stimulation. rTMS
applied in the acute phase of stroke is more effective than rTMS applied in the
chronic phase. Subcortical lesion benefit more from rTMS than other lesion site.

Langue : ANGLAIS