Jun Zhang1, Dongling Zhong1, Xili Xiao2, Li Yuan3, Yuxi Li4, Yaling Zheng5, Juan Li1, Tianyu Liu6, Rongjiang Jin1. 1. School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China. 2. Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China. 3. The General Hospital of Western Theater Command, Chengdu, Sichuan, China. 4. School of Acupuncture Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China. 5. Chengdu Second People's Hospital, Chengdu, Sichuan, China. 6. School of Physical Education, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Abstract
OBJECTIVE: To evaluate the effects and safety of repetitive transcranial magnetic stimulation (rTMS) on aphasia in stroke patients. METHODS: We searched databases from inception to January 28, 2021. Randomized control trials investigating the effects and safety of rTMS for aphasia patients after stroke were included. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Review Manager 5.3 software. The quality of the evidence was assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS: Twenty-eight studies with 1287 patients were included. All studies were assessed at low or unclear risk of bias in one or more domains. The meta-analysis exhibited rTMS was better than sham rTMS and conventional rehabilitation in language recovery. Low-frequency rTMS showed greater improvement in language recovery except for comprehension than sham rTMS. Low-frequency and bilateral rTMS were superior to conventional rehabilitation in language recovery. High-frequency rTMS was no better than sham rTMS and conventional rehabilitation for improving aphasia. The rTMS had better effects in naming, comprehension and aphasia quotient at 20 sessions. Eleven studies reported rTMS was safe for aphasia patients after stroke. The quality of evidence for all outcomes was low or very low, and publication bias may exist. CONCLUSIONS: rTMS may be relatively effective and safe for aphasia patients after stroke. However, these findings should be treated with caution due to high heterogeneity and potential biases.
OBJECTIVE: To evaluate the effects and safety of repetitive transcranial magnetic stimulation (rTMS) on aphasia in stroke patients. METHODS: We searched databases from inception to January 28, 2021. Randomized control trials investigating the effects and safety of rTMS for aphasia patients after stroke were included. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Review Manager 5.3 software. The quality of the evidence was assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS: Twenty-eight studies with 1287 patients were included. All studies were assessed at low or unclear risk of bias in one or more domains. The meta-analysis exhibited rTMS was better than sham rTMS and conventional rehabilitation in language recovery. Low-frequency rTMS showed greater improvement in language recovery except for comprehension than sham rTMS. Low-frequency and bilateral rTMS were superior to conventional rehabilitation in language recovery. High-frequency rTMS was no better than sham rTMS and conventional rehabilitation for improving aphasia. The rTMS had better effects in naming, comprehension and aphasia quotient at 20 sessions. Eleven studies reported rTMS was safe for aphasia patients after stroke. The quality of evidence for all outcomes was low or very low, and publication bias may exist. CONCLUSIONS: rTMS may be relatively effective and safe for aphasia patients after stroke. However, these findings should be treated with caution due to high heterogeneity and potential biases.
Entities:
Keywords:
Aphasia; meta-analysis; repetitive transcranial magnetic stimulation; stroke; systematic review
Authors: Evan H Einstein; Nicholas B Dadario; Hamza Khilji; Justin W Silverstein; Michael E Sughrue; Randy S D'Amico Journal: J Neurooncol Date: 2022-03-25 Impact factor: 4.130
Authors: Ahsan Khan; Kai Yuan; Shi-Chun Bao; Chun Hang Eden Ti; Abdullah Tariq; Nimra Anjum; Raymond Kai-Yu Tong Journal: Front Rehabil Sci Date: 2022-02-10