PMID- 37564368
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230812
IS  - 1662-4548 (Print)
IS  - 1662-453X (Electronic)
IS  - 1662-453X (Linking)
VI  - 17
DP  - 2023
TI  - Motor function improvement and acceptability of non-invasive brain stimulation in 
      patients with Parkinson's disease: a Bayesian network analysis.
PG  - 1212640
LID - 10.3389/fnins.2023.1212640 [doi]
LID - 1212640
AB  - BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disorder defined by 
      progressive motor and non-motor symptoms. Currently, the pro-cognitive effects of 
      transcranial direct current stimulation (tDCS) and repetitive transcranial 
      magnetic stimulation (rTMS) are well-supported in previous literatures. However, 
      controversy surrounding the optimal therapeutic target for motor symptom 
      improvement remains. OBJECTIVE: This network meta-analysis (NMA) was conducted to 
      comprehensively evaluate the optimal strategy to use rTMS and tDCS to improve 
      motor symptoms in PD. METHODS: We searched PubMed, Embase, and Cochrane 
      electronic databases for eligible randomized controlled studies (RCTs). The 
      primary outcome was the changes of Unified Parkinson's Disease Rating Scale 
      (UPDRS) part III score, the secondary outcomes were Time Up and Go Test (TUGT) 
      time, and Freezing of Gait Questionnaire (FOGQ) score. The safety outcome was 
      indicated by device-related adverse events (AEs). RESULT: We enrolled 28 studies 
      that investigated various strategies, including high-frequency rTMS (HFrTMS), 
      low-frequency rTMS (LFrTMS), anodal tDCS (AtDCS), AtDCS_ cathode tDCS (CtDCS), 
      HFrTMS_LFrTMS, and Sham control groups. Both HFrTMS (short-term: mean difference 
      (MD) -5.21, 95% credible interval (CrI) -9.26 to -1.23, long-term: MD -4.74, 95% 
      CrI -6.45 to -3.05), and LFrTMS (long-term: MD -4.83, 95% CrI -6.42 to -3.26) 
      were effective in improving UPDRS-III score compared with Sham stimulation. For 
      TUGT time, HFrTMS (short-term: MD -2.04, 95% CrI -3.26 to -0.8, long-term: MD 
      -2.66, 95% CrI -3.55 to -1.77), and AtDCS (short-term: MD -0.8, 95% CrI -1.26 to 
      -0.34, long-term: MD -0.69, 95% CrI -1.31 to -0.08) produced a significant 
      difference compared to Sham stimulation. However, no statistical difference was 
      found in FOGQ score among the various groups. According to the surface under 
      curve ranking area, HFrTMS ranked first in short-term UPDRS-III score (0.77), 
      short-term (0.82), and long-term (0.84) TUGT time, and short-term FOGQ score 
      (0.73). With respect to the safety outcomes, all strategies indicated few and 
      self-limiting AEs. CONCLUSION: HFrTMS may be the optimal non-invasive brain 
      stimulation (NIBS) intervention to improve motor function in patients with PD 
      while NIBS has generally been well tolerated. However, further studies focusing 
      on the clinical outcomes resulting from the different combined schedules of tDCS 
      and rTMS are required. SYSTEMATIC REVIEW REGISTRATION: 
      https://inplasy.com/inplasy-2023-4-0087/, identifier: 202340087.
CI  - Copyright (c) 2023 Qiu, Yin, Wang, Duan, Xie, Wu, Wang and Chen.
FAU - Qiu, Youjia
AU  - Qiu Y
AD  - Department of Neurosurgery & Brain and Nerve Research Laboratory, The First 
      Affiliated Hospital of Soochow University, Suzhou, China.
FAU - Yin, Ziqian
AU  - Yin Z
AD  - Department of Neurosurgery & Brain and Nerve Research Laboratory, The First 
      Affiliated Hospital of Soochow University, Suzhou, China.
FAU - Wang, Menghan
AU  - Wang M
AD  - Suzhou Medical College of Soochow University, Suzhou, China.
FAU - Duan, Aojie
AU  - Duan A
AD  - Department of Neurosurgery & Brain and Nerve Research Laboratory, The First 
      Affiliated Hospital of Soochow University, Suzhou, China.
FAU - Xie, Minjia
AU  - Xie M
AD  - Department of Neurosurgery & Brain and Nerve Research Laboratory, The First 
      Affiliated Hospital of Soochow University, Suzhou, China.
FAU - Wu, Jiang
AU  - Wu J
AD  - Department of Neurosurgery & Brain and Nerve Research Laboratory, The First 
      Affiliated Hospital of Soochow University, Suzhou, China.
FAU - Wang, Zhong
AU  - Wang Z
AD  - Department of Neurosurgery & Brain and Nerve Research Laboratory, The First 
      Affiliated Hospital of Soochow University, Suzhou, China.
FAU - Chen, Gang
AU  - Chen G
AD  - Department of Neurosurgery & Brain and Nerve Research Laboratory, The First 
      Affiliated Hospital of Soochow University, Suzhou, China.
LA  - eng
PT  - Systematic Review
DEP - 20230726
PL  - Switzerland
TA  - Front Neurosci
JT  - Frontiers in neuroscience
JID - 101478481
PMC - PMC10410144
OTO - NOTNLM
OT  - Parkinson's disease
OT  - meta-analysis
OT  - non-invasive brain stimulation
OT  - repetitive transcranial magnetic stimulation
OT  - transcranial direct current stimulation
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/08/11 06:42
MHDA- 2023/08/11 06:43
PMCR- 2023/01/01
CRDT- 2023/08/11 03:59
PHST- 2023/04/26 00:00 [received]
PHST- 2023/07/11 00:00 [accepted]
PHST- 2023/08/11 06:43 [medline]
PHST- 2023/08/11 06:42 [pubmed]
PHST- 2023/08/11 03:59 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fnins.2023.1212640 [doi]
PST - epublish
SO  - Front Neurosci. 2023 Jul 26;17:1212640. doi: 10.3389/fnins.2023.1212640. 
      eCollection 2023.