磁刺激
冲程(发动机)
背外侧前额叶皮质
荟萃分析
里弗米德脑震荡后症状调查表
认知
蒙特利尔认知评估
随机对照试验
心理学
科克伦图书馆
物理医学与康复
纳入和排除标准
康复
物理疗法
医学
内科学
前额叶皮质
认知障碍
精神科
刺激
工程类
病理
替代医学
机械工程
作者
Kunpeng Li,Jie Sun,Caiqin Wu,Xu-fei An,Jiajia Wu,Mou‐Xiong Zheng,Xu‐Yun Hua,Jian‐Guang Xu
标识
DOI:10.1016/j.bbr.2022.114229
摘要
Post-stroke cognitive impairment (PSCI) is one of the common symptoms in stroke survivors, by which their quality of life and rehabilitation progress are severely limited. Repetitive transcranial magnetic stimulation (rTMS) has been proven to regulate cognition in a non-invasive way. However, the inconsistency in its effectiveness on PSCI reported in previous studies cannot be ruled out. A critical and comprehensive systematic review of rTMS on PSCI patients is necessary. Trials published before the end of February 2022 on rTMS and PSCI were systematically retrieved from PubMed, Cochrane Library, EBSCO, Embase and SCOPUS. High-quality literature was selected following the inclusion and exclusion criteria, with their references being screened. Meta-analysis of data was carried out using RevMan 5.4 software. Ten trials involving 347 participants were included in the current review. Global cognition as measured by MMSE or MoCA (SMD=0.54; 95% CI=0.31, 0.76; P < 0.00001; I 2 = 38%) and modified Barthel index (MD=9.00; 95% CI=2.93, 15.06; P = 0.004; I 2 = 0%) were significantly improved by rTMS compared to sham stimulation in PSCI patients. Performance of the digit symbol test, rivermead behavioral memory test and attention in PSCI patients were also significantly improved. Subgroup analyses showed that significant differences were found in both MoCA and MMSE among PSCI patients by rTMS. MoCA was significantly improved by high frequency rTMS, while both MoCA and MMSE were significantly improved targeting on left dorsolateral prefrontal cortex. rTMS provides a non-invasive and effective technique for the treatment of post-stroke patients with cognitive impairment.
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