Saturday, July 13, 2024

Effectiveness of Noninvasive Brain Stimulation Techniques for Parkinson’s Disease

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In the continuous quest to alleviate the symptoms of Parkinson’s disease (PD), researchers have explored various noninvasive brain stimulation (NIBS) techniques. Utilizing a comprehensive network meta-analysis, they aimed to determine the most effective NIBS methods for improving motor function, cognitive abilities, and depression in PD patients. This analysis included data from multiple databases, ensuring a robust and diverse collection of studies.

A network meta-analysis of randomized controlled trials explored the effectiveness and ranking of different noninvasive brain stimulation (NIBS) techniques for Parkinson’s disease (PD). This extensive study sourced data from PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and SinoMed databases up to April 30th, 2024.

Data Collection and Methodology

Two researchers independently screened the studies based on predefined inclusion and exclusion criteria. The data extraction process involved using an Excel spreadsheet, and the quality of the literature was assessed through the Cochrane Risk of Bias Assessment Tool (RoB2). The meta-analysis was then conducted using StataMP 17.0, incorporating 28 studies with a total of 1628 PD patients.

Findings and Rankings

The results indicated that high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the supplementary motor area (SMA) had the highest effectiveness in enhancing motor function (SMD = – 2.01; 95% CI [- 2.87, – 1.15]). Additionally, HF-rTMS over the primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) also showed significant improvement (SMD = – 1.80; 95% CI [- 2.90, – 0.70]).

Regarding cognitive function, HF-rTMS over the DLPFC outperformed sham stimulation (SMD = 0.80; 95% CI [0.03, 1.56]). The most effective NIBS techniques for cognitive enhancement were identified as anodal transcranial direct current stimulation (a-tDCS) over M1, continuous transcranial direct current stimulation (c-tDCS) over DLPFC, and intermittent theta-burst stimulation (iTBS) over DLPFC.

Key Inferences

Valuable Insights:

  • HF-rTMS over the SMA is the most effective for motor function improvement in PD patients.
  • HF-rTMS and a-tDCS over M1 significantly enhance cognitive functions.
  • HF-rTMS over the DLPFC is beneficial for alleviating depression in PD patients.

In terms of depression, HF-rTMS over the M1 demonstrated substantial improvement (SMD = – 1.43; 95% CI [- 2.26, – 0.61]). The highest-ranked interventions for depression were HF-rTMS over M1, low-frequency rTMS (LF-rTMS) over M1, and HF-rTMS over DLPFC.

This study suggests that HF-rTMS over the SMA may be the optimal choice for motor symptom relief in PD patients. For cognitive and depressive symptoms, a-tDCS and HF-rTMS over M1 show the most promise, respectively. These findings offer crucial insights for clinical applications and future research on NIBS in PD treatment.

Original Article: Sci Rep. 2024 Jun 20;14(1):14219. doi: 10.1038/s41598-024-64196-0.

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