Effect of transcranial magnetic stimulation on Parkinson motor function--systematic review of controlled clinical trials.

The objective of this study was to evaluate the effects of repetitive Transcranial Magnetic Stimulation (rTMS) on motor signs in Parkinson's disease (PD). Medline, Embase, CINAHL, Web of Science, Scopus bibliographic, and Google Scholar databases were searched. Relevant controlled clinical trials published between January 1985 and October 2007 were extracted, reviewed, and validated according to the study protocol. The outcome of interest was the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). We calculated the effect size for the included studies. Sensitivity analysis was performed to further assess factors that may change the results. Ten randomized, controlled clinical trials were included in the meta-analysis. Pooling of the results from these trials yielded an effect size of -0.58 in UPDRS for high-frequency rTMS studies and no significant effects for low-frequency rTMS studies. The benefit of high-frequency rTMS on motor signs in PD was confirmed by the meta-analysis. Lower frequency rTMS had little effect on motor signs in PD. (c) 2008 Movement Disorder Society.