Effectiveness of High- and Low-frequency Repetitive Transcranial Magnetic Stimulation for Treating Dysfunction in Patients with Parkinson’s Disease: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Pu ¹ ,  GOU Yi ^2,3 , LIAO Weijing ¹ , LI Huagang ⁴

1. Department of Rehabilitation Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430077, China;2. Department of Epidemiology, College of Public Health, Wuhan University, Wuhan 430071, China; 3. State Key Lab of Vriology, Wuhan University, Wuhan 430071, China; 4. Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan 430077, China;

Corresponding author：

GOU Yi, Email: guoyi@whu.edu.cn

Keywords：

Repetitive transcranial magnetic stimulation; Dysfunction; Parkinson’s disease; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.20100588

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for treating dysfunction in patients with Parkinson’s disease (PD).
Methods 　We searched the Cochrane Library (Issue 1, 2010), MEDLINE, EMbase, CBMdisc, and CNKI from the date of the database establishment to April 2010. Randomized controlled trials (RCTs) of rTMS for patients with PD were collected. The quality of the included RCTs was critically appraised and data were extracted by two reviewers independently. Meta-analyses were conducted for the eligible RCTs.
Results 　Eight RCTs were included. The pooled results of the first 2 RCTs showed that, there was no significant difference compared with control group about treating PD patients with clinical motor dysfunction by high-frequency rTMS 10 days later (WMD= –4.75, 95%CI –13.73 to 4.23). The pooled analysis of another 3 studies showed that, no significant difference were found about improving symptoms with treatment of low-frequency rTMS for 1 month compared with control group (WDM= –8.51, 95%CI –18.48 to 1.46). The pooled analysis of last 3 studies showed that, patient with treatment of low-frequency rTMS for 3 months, had been significantly improved in clinical symptoms such as neurological, behavior and emotional state, clinical motor function, and activities of daily living (WDM= –5.79, 95%CI –8.44 to –1.13). The frontal or motor cortex rTMS manifested as low frequency (≤1Hz), high intensity (≥90% RMT), multi-frequency (≥3 times) and long time (≥3 months) had a positive effect on the clinical symptoms of patients with PD and also had a long-term effect.
Conclusions 　rTMS can improve clinical symptoms and dysfunction of the patients with PD.

Citation： WANG Pu,GOU Yi,LIAO Weijing,LI Huagang. Effectiveness of High- and Low-frequency Repetitive Transcranial Magnetic Stimulation for Treating Dysfunction in Patients with Parkinson’s Disease: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2010, 10(11): 1308-1315. doi: 10.7507/1672-2531.20100588 Copy

1.	Liu LX, Chen WF, Xie JX, et al. Neuroprotective effects of genistein on dopaminergic neurons in the mice model of Parkinson’s disease. Neurosci Res, 2008, 60(2):156-161.
2.	Faherty CJ, Raviie Shepherd K, Herasimtschuk A, et al. Environmental enrichment in adulthood eliminates neuronal death in experimental Parkinsonism. Brain Res Mol Brain Res, 2005, 134(1): 170-179.
3.	Fahn S, Oakes D, Shoulson I, et al. Levodopa and the progression of Parkinson’s disease. N Engl J Med, 2004, 351(24): 2498-2508.
4.	Stocchi F. The therapeutic concept of continuous dopaminergic stimulation (CDS) in the treatment of Parkinson’s disease. Parkinsonism Relat Disord, 2009, 15(3): 68-71.
5.	Barker AT, Jalinous R, Freeston IL. Non-invasive magnetic stimulotion of human motor cortex . Lancet, 1985, 1(8437): 1106-1107.
6.	Rothwell JC. Techniques and mechanisms of action of transcranial stimulation of a human motor cortex. J Neurosci Methods, 1997, 74(2): 113-122.
7.	Paseual-Leone A, Valls-Solé J, Brasil-Neto JP, et al. Akinesia in Parkinson’s disease.Ⅱ.Effects of subthreshold repetitive transcranial motor cortex stimulation. Neurology, 1994, 44(5): 892-898.
8.	Cantello R, Tarletti R, Civardi C. Transcranial magnetic stimulation and Parkinson’s disease. Brain Research Reviews, 2002, 38(3): 309-327.
9.	Cunnington R, Iansek R,Thickbroom GW, et al. Effects of magnetic stimulation over supplementary motor area on movement in Parkinson’s disease. Brain, 1996, 119(3): 815-822.
10.	Diószeghy P, Hidasi E, Mechler F. Study of central motor functions using magnetic stimulation in Parkinson’s disease. Electromyogr Clin Neurophysiol, 1999, 12(39): 101-105.
11.	Rektorova I, Sedlackova S. Telecka A, et al. Dorsolateral Prefrontal Cortex: A Possible Target for Modulating Dyskinesias in Parkinson’s Disease by Repetitive Transcranial Magnetic Stimulation. Int J Biomed Imaging, 2008 (10): 1155-1161.
12.	Boylan LS, Pullman SL, Lisanby SH, et al. Repetitive transcranial magnetic stimulation to SMA worsens complex movement in Parkinsion’s disease. Clin Neurophysiol, 2001, 112(2): 259-264.
13.	Okabe S, Ugawa Y, Kanazawa I. 0.2-Hz rTMS has no add-on effects as compared to a realistic sham stimulation in Parkinson’s disease. Mov Disord, 2003, 18(4): 382-388.
14.	Ghabra MB, Hallett M, Wassemann EM. Simultaneous repetitive transcranial magnetic stimulation does not speed fine movement in PD. Neurology, 1999, 52: 768-770.
15.	Tergau F, Wassemann EM, Paulus W, et al. Lack of clinical improvement in patients with Parkinsen’s disease after low and high frequency transcranial magnetic stimulation. Electroencephalogr Clin Neurophysiol Suppl, 1999, 51: 281-288.
16.	Goetz CG, Wu J, Michael P, et al. Placebo respones in Parkinson’s disease: Comparisons among 11 trails covering medical and surgical interventions. Mov Disord, 2008, 23(5): 690-699.
17.	Del Olmo MF, Bello O, Cuderio J. Transcranial magnetic stimulation over dorsolateral preforntal cortex in Parkinson’s disease. Clin Neurophysiol, 2007, 118(1): 131-139.
18.	Mally J, Stone TW. Therapeutic and "dose dependent" effect of repetitive microelectroshock induced by transcranial magnetic stimulation in Parkinson’s disease. J Neurosci Res, 1999, 57(6): 935-940.
19.	Siebner HR, Rossmeier C, Mentschel C, et al. Short-term motor improvement after sub-threshold 5-Hz repetitive transcranial magnetic stimulation of the primary motor hand area in Parkinson’s disease. J Neurol Sci, 2000, 178(2): 91-94.
20.	Edelmuth RC, Nitsche MA, Battistella L, et al. Why do some promising brain-stimulation devices fail the next steps of clinical development. Expert Rev Med Devices, 2010, 7(1): 67-97.
21.	Higgins JPT, Green S. Cochrance Handbook for Systematic Reviews of Interventions 4.2.6 2006: The Cochrane Collaboration.
22.	Shimamoto H, Takasaki K, Shigemori M, et al. Therapeutic effect and mechanism of repetitive transcranial magnetic stimulation in Parkinson’s disease. J Neurol, 2001, 248(Suppl 3): 48-52.
23.	Khedr EM, Farweez HM Islam H. Therapeutic effect of repetitive transcranial magnetic stimulation on motor function in Parkinson’s disease patients. Eur J Neurol, 2003, 10(5): 567-572.
24.	Lomarev MP, Wu J, Michael P, et al. Placebo-Controlled Study of rTMS for the Treatment of Parkinson’s Disease. Mov Disord, 2006, 21(3):325-331.
25.	钟跃, 岛本宝哲, 重森稔. 重复经颅磁刺激治疗帕金森病. 现代神经疾病杂志, 2003, 3(4): 228-230.
26.	张鸿, 戴永萍, 苏敏, 等. 重复经颅磁刺激治疗帕金森病的临床研究. 临床神经病学杂志, 2005, 18(4): 266-269.
27.	王铭维, 顾平, 马晓伟, 等. 低频重复经颅磁刺激对帕金森病运动功能和情感障碍的疗效观察. 中华老年医学杂志, 2009, 28(9): 729-732.
28.	Gorsler A, Bäumer T, Weiller C, et al. Interhemispheric effects of high and low frequency rTMS in healthy humans. Clin Neurophysiol, 2003, 114(10): 1800-1807.
29.	Gangitano M, Valero-Cabré A, Tormos JM, et al. Modulation of input–output curves by low and high frequency repetitive transcranial magnetic stimulation of the motor cortex. Clin Neurophysiol, 2002, 113(8): 1249-1257.
30.	Paul B, Fountain FS, Zafiris J, et al. Comprehensive review of the effects of rTMS on motor cortical excitability and inhibition. Clin Neurophysiol, 2006, 117(12): 2584-2596.
31.	Valero-Cabré A, Payne BR, Pascual-Leone A. Opposite impact on 14C-2-deoxyglucose brain metabolism following patterns of high and low frequency repetitive transcranial magnetic stimulation in the posterior parietal cortex. Exp Brain Res, 2007, 176(4): 603-615.
32.	Wassermann EM, Lisanby SH. Therapeutic application of repetitive transeranial magnetic stimulation: a review. Clin Neurophysiol, 2001, 112(8): 1367-1377.
33.	Gershon AA, Dannon PN, Grunhaus L. Transcranial magnetic stimulation in the treatment of depression. Am J Psychiatry, 2003, 160(5): 835-845.
34.	Helmieh RC, Siebner HR, Bakker M, et al. Repetitive transcranial magnetic stimulation to improve mood and motor function in Parkinson’s disease. J Neurol Sci, 2006, 248(2): 84-96.
35.	Edwards MJ, Talelli P, Rothwell JC. Clinical applications of transcranial magnetic stimulation in patients with movement disorders. Lancet Neurol, 2008, 7(9): 827-840.
36.	Bornke Ch, Schulte T, Przuntek H, et al. Clinical effects of repetitive transcranial magnetic stimulation venus acute levodopa challenge in Parkinson’s disease. Neural Transm Suppl, 2004, 68(7): 61-67.
37.	Lefaucheur JP, Drouot X, Yon Raison F, et al. Improvement of motor performance and modulation of conical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson’s disease. Clin Neurophysiol, 2004, 15(6): 2530-2541.
38.	Shimamoto H, Morimitsu H, Sugita S, et al. Therapeutic effect of repetitive transcranial magnetic stimulation in Parkinson’s disease. J Neurol, 1999, 39 (2): 1264-1267.

1. Liu LX, Chen WF, Xie JX, et al. Neuroprotective effects of genistein on dopaminergic neurons in the mice model of Parkinson’s disease. Neurosci Res, 2008, 60(2):156-161.
2. Faherty CJ, Raviie Shepherd K, Herasimtschuk A, et al. Environmental enrichment in adulthood eliminates neuronal death in experimental Parkinsonism. Brain Res Mol Brain Res, 2005, 134(1): 170-179.
3. Fahn S, Oakes D, Shoulson I, et al. Levodopa and the progression of Parkinson’s disease. N Engl J Med, 2004, 351(24): 2498-2508.
4. Stocchi F. The therapeutic concept of continuous dopaminergic stimulation (CDS) in the treatment of Parkinson’s disease. Parkinsonism Relat Disord, 2009, 15(3): 68-71.
5. Barker AT, Jalinous R, Freeston IL. Non-invasive magnetic stimulotion of human motor cortex . Lancet, 1985, 1(8437): 1106-1107.
6. Rothwell JC. Techniques and mechanisms of action of transcranial stimulation of a human motor cortex. J Neurosci Methods, 1997, 74(2): 113-122.
7. Paseual-Leone A, Valls-Solé J, Brasil-Neto JP, et al. Akinesia in Parkinson’s disease.Ⅱ.Effects of subthreshold repetitive transcranial motor cortex stimulation. Neurology, 1994, 44(5): 892-898.
8. Cantello R, Tarletti R, Civardi C. Transcranial magnetic stimulation and Parkinson’s disease. Brain Research Reviews, 2002, 38(3): 309-327.
9. Cunnington R, Iansek R,Thickbroom GW, et al. Effects of magnetic stimulation over supplementary motor area on movement in Parkinson’s disease. Brain, 1996, 119(3): 815-822.
10. Diószeghy P, Hidasi E, Mechler F. Study of central motor functions using magnetic stimulation in Parkinson’s disease. Electromyogr Clin Neurophysiol, 1999, 12(39): 101-105.
11. Rektorova I, Sedlackova S. Telecka A, et al. Dorsolateral Prefrontal Cortex: A Possible Target for Modulating Dyskinesias in Parkinson’s Disease by Repetitive Transcranial Magnetic Stimulation. Int J Biomed Imaging, 2008 (10): 1155-1161.
12. Boylan LS, Pullman SL, Lisanby SH, et al. Repetitive transcranial magnetic stimulation to SMA worsens complex movement in Parkinsion’s disease. Clin Neurophysiol, 2001, 112(2): 259-264.
13. Okabe S, Ugawa Y, Kanazawa I. 0.2-Hz rTMS has no add-on effects as compared to a realistic sham stimulation in Parkinson’s disease. Mov Disord, 2003, 18(4): 382-388.
14. Ghabra MB, Hallett M, Wassemann EM. Simultaneous repetitive transcranial magnetic stimulation does not speed fine movement in PD. Neurology, 1999, 52: 768-770.
15. Tergau F, Wassemann EM, Paulus W, et al. Lack of clinical improvement in patients with Parkinsen’s disease after low and high frequency transcranial magnetic stimulation. Electroencephalogr Clin Neurophysiol Suppl, 1999, 51: 281-288.
16. Goetz CG, Wu J, Michael P, et al. Placebo respones in Parkinson’s disease: Comparisons among 11 trails covering medical and surgical interventions. Mov Disord, 2008, 23(5): 690-699.
17. Del Olmo MF, Bello O, Cuderio J. Transcranial magnetic stimulation over dorsolateral preforntal cortex in Parkinson’s disease. Clin Neurophysiol, 2007, 118(1): 131-139.
18. Mally J, Stone TW. Therapeutic and "dose dependent" effect of repetitive microelectroshock induced by transcranial magnetic stimulation in Parkinson’s disease. J Neurosci Res, 1999, 57(6): 935-940.
19. Siebner HR, Rossmeier C, Mentschel C, et al. Short-term motor improvement after sub-threshold 5-Hz repetitive transcranial magnetic stimulation of the primary motor hand area in Parkinson’s disease. J Neurol Sci, 2000, 178(2): 91-94.
20. Edelmuth RC, Nitsche MA, Battistella L, et al. Why do some promising brain-stimulation devices fail the next steps of clinical development. Expert Rev Med Devices, 2010, 7(1): 67-97.
21. Higgins JPT, Green S. Cochrance Handbook for Systematic Reviews of Interventions 4.2.6 2006: The Cochrane Collaboration.
22. Shimamoto H, Takasaki K, Shigemori M, et al. Therapeutic effect and mechanism of repetitive transcranial magnetic stimulation in Parkinson’s disease. J Neurol, 2001, 248(Suppl 3): 48-52.
23. Khedr EM, Farweez HM Islam H. Therapeutic effect of repetitive transcranial magnetic stimulation on motor function in Parkinson’s disease patients. Eur J Neurol, 2003, 10(5): 567-572.
24. Lomarev MP, Wu J, Michael P, et al. Placebo-Controlled Study of rTMS for the Treatment of Parkinson’s Disease. Mov Disord, 2006, 21(3):325-331.
25. 钟跃, 岛本宝哲, 重森稔. 重复经颅磁刺激治疗帕金森病. 现代神经疾病杂志, 2003, 3(4): 228-230.
26. 张鸿, 戴永萍, 苏敏, 等. 重复经颅磁刺激治疗帕金森病的临床研究. 临床神经病学杂志, 2005, 18(4): 266-269.
27. 王铭维, 顾平, 马晓伟, 等. 低频重复经颅磁刺激对帕金森病运动功能和情感障碍的疗效观察. 中华老年医学杂志, 2009, 28(9): 729-732.
28. Gorsler A, Bäumer T, Weiller C, et al. Interhemispheric effects of high and low frequency rTMS in healthy humans. Clin Neurophysiol, 2003, 114(10): 1800-1807.
29. Gangitano M, Valero-Cabré A, Tormos JM, et al. Modulation of input–output curves by low and high frequency repetitive transcranial magnetic stimulation of the motor cortex. Clin Neurophysiol, 2002, 113(8): 1249-1257.
30. Paul B, Fountain FS, Zafiris J, et al. Comprehensive review of the effects of rTMS on motor cortical excitability and inhibition. Clin Neurophysiol, 2006, 117(12): 2584-2596.
31. Valero-Cabré A, Payne BR, Pascual-Leone A. Opposite impact on 14C-2-deoxyglucose brain metabolism following patterns of high and low frequency repetitive transcranial magnetic stimulation in the posterior parietal cortex. Exp Brain Res, 2007, 176(4): 603-615.
32. Wassermann EM, Lisanby SH. Therapeutic application of repetitive transeranial magnetic stimulation: a review. Clin Neurophysiol, 2001, 112(8): 1367-1377.
33. Gershon AA, Dannon PN, Grunhaus L. Transcranial magnetic stimulation in the treatment of depression. Am J Psychiatry, 2003, 160(5): 835-845.
34. Helmieh RC, Siebner HR, Bakker M, et al. Repetitive transcranial magnetic stimulation to improve mood and motor function in Parkinson’s disease. J Neurol Sci, 2006, 248(2): 84-96.
35. Edwards MJ, Talelli P, Rothwell JC. Clinical applications of transcranial magnetic stimulation in patients with movement disorders. Lancet Neurol, 2008, 7(9): 827-840.
36. Bornke Ch, Schulte T, Przuntek H, et al. Clinical effects of repetitive transcranial magnetic stimulation venus acute levodopa challenge in Parkinson’s disease. Neural Transm Suppl, 2004, 68(7): 61-67.
37. Lefaucheur JP, Drouot X, Yon Raison F, et al. Improvement of motor performance and modulation of conical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson’s disease. Clin Neurophysiol, 2004, 15(6): 2530-2541.
38. Shimamoto H, Morimitsu H, Sugita S, et al. Therapeutic effect of repetitive transcranial magnetic stimulation in Parkinson’s disease. J Neurol, 1999, 39 (2): 1264-1267.

Chinese Journal of Evidence-Based Medicine

Effectiveness of High- and Low-frequency Repetitive Transcranial Magnetic Stimulation for Treating Dysfunction in Patients with Parkinson’s Disease: A Meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content