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Does repetitive transcranial magnetic stimulation have a beneficial effect on improving unilateral spatial neglect caused by stroke? A meta-analysis
This review aimed to assess the effect of repetitive transcranial magnetic stimulation (rTMS) in improving post-stroke unilateral spatial neglect (USN) using a meta-analysis. Further, we aimed to identify any association between rTMS parameters, patient demographics, and treatment effect sizes using...
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| Published in: | Journal of neurology 2024-10, Vol.271 (10), p.6494-6507 |
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| container_end_page | 6507 |
| container_issue | 10 |
| container_start_page | 6494 |
| container_title | Journal of neurology |
| container_volume | 271 |
| creator | Lin, Ruixuan Zhang, Jack Jiaqi Zhong, Lingling Chan, Sofina S. Y. Kwong, Patrick W. H. Lorentz, Lukas Shaikh, Usman Jawed Lam, Tommy L. H. Mehler, David M. A. Fong, Kenneth N. K. |
| description | This review aimed to assess the effect of repetitive transcranial magnetic stimulation (rTMS) in improving post-stroke unilateral spatial neglect (USN) using a meta-analysis. Further, we aimed to identify any association between rTMS parameters, patient demographics, and treatment effect sizes using subgroup analyses and meta-regression. A literature search was conducted through four databases from inception to March 6, 2024, to retrieve all relevant controlled trials investigating the effects of rTMS on symptoms of USN in post-stroke patients. Overall, rTMS significantly improved post-stroke USN, as measured by the line bisection test (Hedges’
g
= – 1.301,
p
|
| doi_str_mv | 10.1007/s00415-024-12612-w |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11446973</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3097855943</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-bbb9ae0c0a99c464aac932e83ae7684532b60a1847a7489455673b56080319583</originalsourceid><addsrcrecordid>eNp9kUtv1TAQhS0EopfCH2CBLLFhE7DjR-JVVbXlIVViA2tr4k5Sl8QOdnKr-z_4wfXllvJYsPEszjfHc3QIecnZW85Y8y4zJrmqWC0rXmteV7ePyIZLUVdcKvOYbJiQrFJCySPyLOcbxlhbhKfkSBhutDBqQ36cR8w04YyLX_wW6ZIgZFceDyOdYAhFcDQvflpHWHwM9BoKBrTDgL13ewz7Ht1Ci-anOcWtDwNdgy88piLnuSyWGXAY95yDNeMV7XbFNsVveEJP6YQLVBBg3GWfn5MnPYwZX9zPY_L1_cWXs4_V5ecPn85OLysnlF6qrusMIHMMjHFSSwBnRI2tAGx0SSrqTjPgrWygka2RSulGdEqzlgluVCuOycnBd167Ca8chpJ-tHPyE6SdjeDt30rw13aIW8u5lNo0oji8uXdI8fuKebGTzw7HEQLGNVvBTNMqZeQeff0PehPXVBIXivO61o1qZKHqA-VSzDlh_3ANZ3bfuj20bkvr9mfr9rYsvfozx8PKr5oLIA5ALlIYMP3--z-2d8k0u3w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3112267574</pqid></control><display><type>article</type><title>Does repetitive transcranial magnetic stimulation have a beneficial effect on improving unilateral spatial neglect caused by stroke? A meta-analysis</title><source>Springer Link</source><creator>Lin, Ruixuan ; Zhang, Jack Jiaqi ; Zhong, Lingling ; Chan, Sofina S. Y. ; Kwong, Patrick W. H. ; Lorentz, Lukas ; Shaikh, Usman Jawed ; Lam, Tommy L. H. ; Mehler, David M. A. ; Fong, Kenneth N. K.</creator><creatorcontrib>Lin, Ruixuan ; Zhang, Jack Jiaqi ; Zhong, Lingling ; Chan, Sofina S. Y. ; Kwong, Patrick W. H. ; Lorentz, Lukas ; Shaikh, Usman Jawed ; Lam, Tommy L. H. ; Mehler, David M. A. ; Fong, Kenneth N. K.</creatorcontrib><description>This review aimed to assess the effect of repetitive transcranial magnetic stimulation (rTMS) in improving post-stroke unilateral spatial neglect (USN) using a meta-analysis. Further, we aimed to identify any association between rTMS parameters, patient demographics, and treatment effect sizes using subgroup analyses and meta-regression. A literature search was conducted through four databases from inception to March 6, 2024, to retrieve all relevant controlled trials investigating the effects of rTMS on symptoms of USN in post-stroke patients. Overall, rTMS significantly improved post-stroke USN, as measured by the line bisection test (Hedges’
g
= – 1.301,
p
< 0.0001), the cancelation test (Hedge’s
g
= – 1.512,
p
< 0.0001), and the Catherine Bergego Scale (Hedges’g = – 0.770,
p
< 0.0001), compared to sham stimulation. Subgroup analysis found that generally larger effect sizes following excitatory rTMS across several outcome measures, indicating that excitatory rTMS on the ipsilesional hemisphere may be more effective than inhibitory rTMS on the contralesional hemisphere in ameliorating neglect symptoms. Meta-regression analysis of the line bisection test showed a significant difference in the chronicity of stroke patients, suggesting that rTMS may be more effective for USN in patients at the acute stage (within 3 months since stroke) than in those at the post-acute stage (
p
= 0.035). In conclusion, rTMS appears to be effective in promoting recovery from post-stroke USN. Excitatory protocols and early intervention may enhance recovery outcomes for neglect behaviors in post-stroke survivors.</description><identifier>ISSN: 0340-5354</identifier><identifier>ISSN: 1432-1459</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-024-12612-w</identifier><identifier>PMID: 39196395</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Clinical trials ; Humans ; Magnetic fields ; Medicine ; Medicine & Public Health ; Meta-analysis ; Neglect syndromes ; Neurology ; Neuroradiology ; Neurosciences ; Outcome Assessment, Health Care ; Perceptual Disorders - etiology ; Perceptual Disorders - rehabilitation ; Perceptual Disorders - therapy ; Review ; Stroke ; Stroke - complications ; Stroke - therapy ; Stroke Rehabilitation - methods ; Transcranial magnetic stimulation ; Transcranial Magnetic Stimulation - methods</subject><ispartof>Journal of neurology, 2024-10, Vol.271 (10), p.6494-6507</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-bbb9ae0c0a99c464aac932e83ae7684532b60a1847a7489455673b56080319583</cites><orcidid>0000-0002-4656-1909</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39196395$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Ruixuan</creatorcontrib><creatorcontrib>Zhang, Jack Jiaqi</creatorcontrib><creatorcontrib>Zhong, Lingling</creatorcontrib><creatorcontrib>Chan, Sofina S. Y.</creatorcontrib><creatorcontrib>Kwong, Patrick W. H.</creatorcontrib><creatorcontrib>Lorentz, Lukas</creatorcontrib><creatorcontrib>Shaikh, Usman Jawed</creatorcontrib><creatorcontrib>Lam, Tommy L. H.</creatorcontrib><creatorcontrib>Mehler, David M. A.</creatorcontrib><creatorcontrib>Fong, Kenneth N. K.</creatorcontrib><title>Does repetitive transcranial magnetic stimulation have a beneficial effect on improving unilateral spatial neglect caused by stroke? A meta-analysis</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>This review aimed to assess the effect of repetitive transcranial magnetic stimulation (rTMS) in improving post-stroke unilateral spatial neglect (USN) using a meta-analysis. Further, we aimed to identify any association between rTMS parameters, patient demographics, and treatment effect sizes using subgroup analyses and meta-regression. A literature search was conducted through four databases from inception to March 6, 2024, to retrieve all relevant controlled trials investigating the effects of rTMS on symptoms of USN in post-stroke patients. Overall, rTMS significantly improved post-stroke USN, as measured by the line bisection test (Hedges’
g
= – 1.301,
p
< 0.0001), the cancelation test (Hedge’s
g
= – 1.512,
p
< 0.0001), and the Catherine Bergego Scale (Hedges’g = – 0.770,
p
< 0.0001), compared to sham stimulation. Subgroup analysis found that generally larger effect sizes following excitatory rTMS across several outcome measures, indicating that excitatory rTMS on the ipsilesional hemisphere may be more effective than inhibitory rTMS on the contralesional hemisphere in ameliorating neglect symptoms. Meta-regression analysis of the line bisection test showed a significant difference in the chronicity of stroke patients, suggesting that rTMS may be more effective for USN in patients at the acute stage (within 3 months since stroke) than in those at the post-acute stage (
p
= 0.035). In conclusion, rTMS appears to be effective in promoting recovery from post-stroke USN. Excitatory protocols and early intervention may enhance recovery outcomes for neglect behaviors in post-stroke survivors.</description><subject>Clinical trials</subject><subject>Humans</subject><subject>Magnetic fields</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Neglect syndromes</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Outcome Assessment, Health Care</subject><subject>Perceptual Disorders - etiology</subject><subject>Perceptual Disorders - rehabilitation</subject><subject>Perceptual Disorders - therapy</subject><subject>Review</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - therapy</subject><subject>Stroke Rehabilitation - methods</subject><subject>Transcranial magnetic stimulation</subject><subject>Transcranial Magnetic Stimulation - methods</subject><issn>0340-5354</issn><issn>1432-1459</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kUtv1TAQhS0EopfCH2CBLLFhE7DjR-JVVbXlIVViA2tr4k5Sl8QOdnKr-z_4wfXllvJYsPEszjfHc3QIecnZW85Y8y4zJrmqWC0rXmteV7ePyIZLUVdcKvOYbJiQrFJCySPyLOcbxlhbhKfkSBhutDBqQ36cR8w04YyLX_wW6ZIgZFceDyOdYAhFcDQvflpHWHwM9BoKBrTDgL13ewz7Ht1Ci-anOcWtDwNdgy88piLnuSyWGXAY95yDNeMV7XbFNsVveEJP6YQLVBBg3GWfn5MnPYwZX9zPY_L1_cWXs4_V5ecPn85OLysnlF6qrusMIHMMjHFSSwBnRI2tAGx0SSrqTjPgrWygka2RSulGdEqzlgluVCuOycnBd167Ca8chpJ-tHPyE6SdjeDt30rw13aIW8u5lNo0oji8uXdI8fuKebGTzw7HEQLGNVvBTNMqZeQeff0PehPXVBIXivO61o1qZKHqA-VSzDlh_3ANZ3bfuj20bkvr9mfr9rYsvfozx8PKr5oLIA5ALlIYMP3--z-2d8k0u3w</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Lin, Ruixuan</creator><creator>Zhang, Jack Jiaqi</creator><creator>Zhong, Lingling</creator><creator>Chan, Sofina S. Y.</creator><creator>Kwong, Patrick W. H.</creator><creator>Lorentz, Lukas</creator><creator>Shaikh, Usman Jawed</creator><creator>Lam, Tommy L. H.</creator><creator>Mehler, David M. A.</creator><creator>Fong, Kenneth N. K.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4656-1909</orcidid></search><sort><creationdate>20241001</creationdate><title>Does repetitive transcranial magnetic stimulation have a beneficial effect on improving unilateral spatial neglect caused by stroke? A meta-analysis</title><author>Lin, Ruixuan ; Zhang, Jack Jiaqi ; Zhong, Lingling ; Chan, Sofina S. Y. ; Kwong, Patrick W. H. ; Lorentz, Lukas ; Shaikh, Usman Jawed ; Lam, Tommy L. H. ; Mehler, David M. A. ; Fong, Kenneth N. K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-bbb9ae0c0a99c464aac932e83ae7684532b60a1847a7489455673b56080319583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Clinical trials</topic><topic>Humans</topic><topic>Magnetic fields</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Neglect syndromes</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Outcome Assessment, Health Care</topic><topic>Perceptual Disorders - etiology</topic><topic>Perceptual Disorders - rehabilitation</topic><topic>Perceptual Disorders - therapy</topic><topic>Review</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Stroke - therapy</topic><topic>Stroke Rehabilitation - methods</topic><topic>Transcranial magnetic stimulation</topic><topic>Transcranial Magnetic Stimulation - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Ruixuan</creatorcontrib><creatorcontrib>Zhang, Jack Jiaqi</creatorcontrib><creatorcontrib>Zhong, Lingling</creatorcontrib><creatorcontrib>Chan, Sofina S. Y.</creatorcontrib><creatorcontrib>Kwong, Patrick W. H.</creatorcontrib><creatorcontrib>Lorentz, Lukas</creatorcontrib><creatorcontrib>Shaikh, Usman Jawed</creatorcontrib><creatorcontrib>Lam, Tommy L. H.</creatorcontrib><creatorcontrib>Mehler, David M. A.</creatorcontrib><creatorcontrib>Fong, Kenneth N. K.</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Ruixuan</au><au>Zhang, Jack Jiaqi</au><au>Zhong, Lingling</au><au>Chan, Sofina S. Y.</au><au>Kwong, Patrick W. H.</au><au>Lorentz, Lukas</au><au>Shaikh, Usman Jawed</au><au>Lam, Tommy L. H.</au><au>Mehler, David M. A.</au><au>Fong, Kenneth N. K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does repetitive transcranial magnetic stimulation have a beneficial effect on improving unilateral spatial neglect caused by stroke? A meta-analysis</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2024-10-01</date><risdate>2024</risdate><volume>271</volume><issue>10</issue><spage>6494</spage><epage>6507</epage><pages>6494-6507</pages><issn>0340-5354</issn><issn>1432-1459</issn><eissn>1432-1459</eissn><abstract>This review aimed to assess the effect of repetitive transcranial magnetic stimulation (rTMS) in improving post-stroke unilateral spatial neglect (USN) using a meta-analysis. Further, we aimed to identify any association between rTMS parameters, patient demographics, and treatment effect sizes using subgroup analyses and meta-regression. A literature search was conducted through four databases from inception to March 6, 2024, to retrieve all relevant controlled trials investigating the effects of rTMS on symptoms of USN in post-stroke patients. Overall, rTMS significantly improved post-stroke USN, as measured by the line bisection test (Hedges’
g
= – 1.301,
p
< 0.0001), the cancelation test (Hedge’s
g
= – 1.512,
p
< 0.0001), and the Catherine Bergego Scale (Hedges’g = – 0.770,
p
< 0.0001), compared to sham stimulation. Subgroup analysis found that generally larger effect sizes following excitatory rTMS across several outcome measures, indicating that excitatory rTMS on the ipsilesional hemisphere may be more effective than inhibitory rTMS on the contralesional hemisphere in ameliorating neglect symptoms. Meta-regression analysis of the line bisection test showed a significant difference in the chronicity of stroke patients, suggesting that rTMS may be more effective for USN in patients at the acute stage (within 3 months since stroke) than in those at the post-acute stage (
p
= 0.035). In conclusion, rTMS appears to be effective in promoting recovery from post-stroke USN. Excitatory protocols and early intervention may enhance recovery outcomes for neglect behaviors in post-stroke survivors.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39196395</pmid><doi>10.1007/s00415-024-12612-w</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-4656-1909</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Clinical trials Humans Magnetic fields Medicine Medicine & Public Health Meta-analysis Neglect syndromes Neurology Neuroradiology Neurosciences Outcome Assessment, Health Care Perceptual Disorders - etiology Perceptual Disorders - rehabilitation Perceptual Disorders - therapy Review Stroke Stroke - complications Stroke - therapy Stroke Rehabilitation - methods Transcranial magnetic stimulation Transcranial Magnetic Stimulation - methods |
| title | Does repetitive transcranial magnetic stimulation have a beneficial effect on improving unilateral spatial neglect caused by stroke? A meta-analysis |
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