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Comparative efficacy of transcranial magnetic stimulation on different targets in Parkinson’s disease: A Bayesian network meta-analysis
BACKGROUND/OBJECTIVE: The efficacy of transcranial magnetic stimulation (TMS) on Parkinson’s disease (PD) varies across the stimulation targets. This study aims to estimate the effect of different TMS targets on motor symptoms in PD. METHODS: A Bayesian hierarchical model was built to assess the eff...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845788/ https://www.ncbi.nlm.nih.gov/pubmed/36688161 http://dx.doi.org/10.3389/fnagi.2022.1073310 |
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author | Dong, Ke Zhu, Xiaoxia Xiao, Wenwu Gan, Chu Luo, Yulu Jiang, Manying Liu, Hanjun Chen, Xi |
author_facet | Dong, Ke Zhu, Xiaoxia Xiao, Wenwu Gan, Chu Luo, Yulu Jiang, Manying Liu, Hanjun Chen, Xi |
author_sort | Dong, Ke |
collection | PubMed |
description | BACKGROUND/OBJECTIVE: The efficacy of transcranial magnetic stimulation (TMS) on Parkinson’s disease (PD) varies across the stimulation targets. This study aims to estimate the effect of different TMS targets on motor symptoms in PD. METHODS: A Bayesian hierarchical model was built to assess the effects across different TMS targets, and the rank probabilities and the surface under the cumulative ranking curve (SUCRA) values were calculated to determine the ranks of each target. The primary outcome was the Unified Parkinson’s Disease Rating Scale part-III. Inconsistency between direct and indirect comparisons was assessed using the node-splitting method. RESULTS: Thirty-six trials with 1,122 subjects were included for analysis. The pair-wise meta-analysis results showed that TMS could significantly improve motor symptoms in PD patients. Network meta-analysis results showed that the high-frequency stimulation over bilateral M1, bilateral DLPFC, and M1+DLPFC could significantly reduce the UPDRS-III scores compared with sham conditions. The high-frequency stimulation over both M1 and DLPFC had a more significant effect when compared with other parameters, and ranked first with the highest SCURA value. There was no significant inconsistency between direct and indirect comparisons. CONCLUSION: Considering all settings reported in our research, high-frequency stimulation over bilateral M1 or bilateral DLPFC has a moderate beneficial effect on the improvement of motor symptoms in PD (high confidence rating). High-frequency stimulation over M1+DLPFC has a prominent beneficial effect and appears to be the most effective TMS parameter setting for ameliorating motor symptoms of PD patients (high confidence rating). |
format | Online Article Text |
id | pubmed-9845788 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98457882023-01-19 Comparative efficacy of transcranial magnetic stimulation on different targets in Parkinson’s disease: A Bayesian network meta-analysis Dong, Ke Zhu, Xiaoxia Xiao, Wenwu Gan, Chu Luo, Yulu Jiang, Manying Liu, Hanjun Chen, Xi Front Aging Neurosci Neuroscience BACKGROUND/OBJECTIVE: The efficacy of transcranial magnetic stimulation (TMS) on Parkinson’s disease (PD) varies across the stimulation targets. This study aims to estimate the effect of different TMS targets on motor symptoms in PD. METHODS: A Bayesian hierarchical model was built to assess the effects across different TMS targets, and the rank probabilities and the surface under the cumulative ranking curve (SUCRA) values were calculated to determine the ranks of each target. The primary outcome was the Unified Parkinson’s Disease Rating Scale part-III. Inconsistency between direct and indirect comparisons was assessed using the node-splitting method. RESULTS: Thirty-six trials with 1,122 subjects were included for analysis. The pair-wise meta-analysis results showed that TMS could significantly improve motor symptoms in PD patients. Network meta-analysis results showed that the high-frequency stimulation over bilateral M1, bilateral DLPFC, and M1+DLPFC could significantly reduce the UPDRS-III scores compared with sham conditions. The high-frequency stimulation over both M1 and DLPFC had a more significant effect when compared with other parameters, and ranked first with the highest SCURA value. There was no significant inconsistency between direct and indirect comparisons. CONCLUSION: Considering all settings reported in our research, high-frequency stimulation over bilateral M1 or bilateral DLPFC has a moderate beneficial effect on the improvement of motor symptoms in PD (high confidence rating). High-frequency stimulation over M1+DLPFC has a prominent beneficial effect and appears to be the most effective TMS parameter setting for ameliorating motor symptoms of PD patients (high confidence rating). Frontiers Media S.A. 2023-01-04 /pmc/articles/PMC9845788/ /pubmed/36688161 http://dx.doi.org/10.3389/fnagi.2022.1073310 Text en Copyright © 2023 Dong, Zhu, Xiao, Gan, Luo, Jiang, Liu and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Dong, Ke Zhu, Xiaoxia Xiao, Wenwu Gan, Chu Luo, Yulu Jiang, Manying Liu, Hanjun Chen, Xi Comparative efficacy of transcranial magnetic stimulation on different targets in Parkinson’s disease: A Bayesian network meta-analysis |
title | Comparative efficacy of transcranial magnetic stimulation on different targets in Parkinson’s disease: A Bayesian network meta-analysis |
title_full | Comparative efficacy of transcranial magnetic stimulation on different targets in Parkinson’s disease: A Bayesian network meta-analysis |
title_fullStr | Comparative efficacy of transcranial magnetic stimulation on different targets in Parkinson’s disease: A Bayesian network meta-analysis |
title_full_unstemmed | Comparative efficacy of transcranial magnetic stimulation on different targets in Parkinson’s disease: A Bayesian network meta-analysis |
title_short | Comparative efficacy of transcranial magnetic stimulation on different targets in Parkinson’s disease: A Bayesian network meta-analysis |
title_sort | comparative efficacy of transcranial magnetic stimulation on different targets in parkinson’s disease: a bayesian network meta-analysis |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845788/ https://www.ncbi.nlm.nih.gov/pubmed/36688161 http://dx.doi.org/10.3389/fnagi.2022.1073310 |
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