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Transcranial and spinal cord magnetic stimulation in treatment of spasticity. A literature review and meta--analysisстатья
Статья опубликована в высокорейтинговом журнале
Информация о цитировании статьи получена из
Web of Science,
Scopus
Статья опубликована в журнале из списка Web of Science и/или Scopus
Дата последнего поиска статьи во внешних источниках: 2 мая 2018 г.
- Авторы: Korzhova J., Sinitsyn D., Chervyakov A., Poydasheva A., Zakharova M., Suponeva N., Chernikova L., Piradov M.
- Журнал: European Journal of Physical and Rehabilitation Medicine
- Том: 54
- Номер: 1
- Год издания: 2018
- Издательство: Edizioni Minerva Medica
- Местоположение издательства: Italy
- Первая страница: 75
- Последняя страница: 84
- Аннотация: INTRODUCTION: Spasticity is associated with various diseases of the nervous system. Current treatments such as drug therapy, botulinum toxin injections, kinesitherapy, and physiotherapy are not sufficiently effective in a large number of patients. Transcranial magnetic stimulation (TMS) can be considered as an alternative method of treatment. The purpose of this article is to conduct a systematic review and metaanalysis of all available publications assessing the efficacy of repetitive TMS in treatment of spasticity. EVIDENCE ACQUISITION: Search for articles was conducted in databases PubMed, Willey, and Google. Keywords included “TMS”, “spasticity”, “TMS and spasticity”, “non invasive brain stimulation”, and “noninvasive spinal cord stimulation”. The difference in scores according to the Modified Ashworth Scale (MAS) for one joint before and after treatment was taken as the effect size. EVIDENCE SYNTHESIS: We found 26 articles that examined the TMS efficacy in treatment of spasticity. Metaanalysis included 6 trials comprising 149 patients who underwent real stimulation or simulation. No statistically significant difference in the effect of real and simulated stimulation was found in stroke patients. In patients with spinal cord injury and spasticity, the mean effect size value and the 95% confidence interval (CI) were −0.80 and (−1.12, −0.49), respectively, in a group of real stimulation; in the case of simulated stimulation, these parameters were 0.15 and (−0.30, −0.00), respectively. Statistically significant differences between groups of real stimulation and simulation were demonstrated for using highfrequency repetitive TMS or iTBS mode for the M1 area of the spastic leg (p=0.0002). CONCLUSIONS: According to the metaanalysis, the statistically significant effect of TMS in the form of reduced spasticity was demonstrated only for the developed due to lesions at the brain stem and spinal cord level. To clarify the amount of the antispasmodic effect of repetitive TMS at other lesion levels, in particular in patients with hemispheric stroke, further research is required.
- Добавил в систему: Пойдашева Александра Георгиевна