Non-invasive brain stimulation for Parkinson’s disease: a systematic review and meta-analysis of the literature

• Published in: Journal of Neurology, Neurosurgery and Psychiatry Vol. 76; no. 12; pp. 1614 - 1623
• Main Authors: Fregni, F, Simon, D K, Wu, A, Pascual-Leone, A
• Format: Journal Article Book Review
• Language: English
• Published: England BMJ Publishing Group Ltd 01-12-2005; BMJ Publishing Group LTD; BMJ Group
• Subjects: 95% CI; 95% confidence interval; DBS; deep brain stimulation; ECT; Electroconvulsive Therapy; Humans; meta-analysis; Motor Skills Disorders - etiology; Motor Skills Disorders - therapy; Parkinson Disease - therapy; Parkinson’s disease; Radiation; repetitive transcranial magnetic stimulation; Review; rTMS; Severity of Illness Index; standard deviation; Systematic review; TMS; transcranial magnetic stimulation; Treatment Outcome; Unified Parkinson’s Disease Rating Scale; UPDRS
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2005.069849

A systematic review and meta-analysis were conducted to quantify the efficacy of transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT) for the treatment of motor dysfunction in patients with Parkinson’s disease (PD). Prospective studies which evaluated the effects of either TMS (12 studies) or ECT (five studies) on motor function in PD using the motor subscale of the Unified Parkinson’s Disease Rating Scale (UPDRS) for TMS studies and any continuous measures of motor function in PD for ECT studies were included. The pooled effect size (standardised mean difference between pre-treatment versus post-treatment means) from a random effects model was 0.62 (95% confidence interval: 0.38, 0.85) for TMS treatment and 1.68 (0.79, 2.56) for ECT treatment, and from a fixed effects model was 0.59 (0.39, 0.78) for TMS treatment and 1.55 (1.07, 2.03) for ECT treatment. TMS, across applied stimulation sites and parameters, can exert a significant, albeit modest, positive effect on the motor function of patients with PD. ECT also may exert a significant effect on motor function in PD patients.