Repetitive transcranial magnetic stimulation improves cognition, depression, and walking ability in patients with Parkinson's disease: a meta-analysis

重复经颅磁刺激改善帕金森病患者的认知、抑郁和行走能力:一项荟萃分析

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Abstract

OBJECTIVE: To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on cognitive function, depression, and walking ability in patients with Parkinson's disease. METHODS: A comprehensive search was conducted in PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database, and Wanfang Database. Randomized controlled trials (RCTs) on rTMS treatment in Parkinson's disease patients were retrieved, covering the period from the inception of each database to July 2024. The quality of the included studies was assessed using the Cochrane risk of bias tool. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the studies. Data synthesis and analysis were performed using RevMan 5.4 and Stata 17.0 software. RESULTS: A total of 15 studies were included. The meta-analysis revealed that rTMS significantly improved the MOCA score (MD = 2.98, 95% CI 2.08, 3.88, P = 0.000), TUGT score (SMD=-0.72, 95% CI -1.43, 0.00, P = 0.048), FOG-Q score (SMD=-0.54, 95% CI -0.97, -0.11, P = 0.01), and UPDRS-III score (SMD=-0.66, 95% CI -0.84, -0.47, P = 0.000) in Parkinson's disease patients, and also alleviated depressive symptoms as measured by the HAMD (SMD=-0.43, 95% CI -0.72, -0.13, P = 0.004). CONCLUSIONS: rTMS can improve cognitive function, depressive symptoms, and walking ability in patients with Parkinson's disease.

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