Effects of Non-Invasive Brain Stimulation on Post-Stroke Spasticity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Wang, Xiaohan; Liu, Ge; Hu, Huijing; Li, Yan; Li, Le

doi:10.3390/brainsci12070836

Cited by 18 publications

(24 citation statements)

References 56 publications

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“…Spasticity is common after cerebral insults like stroke. A recent systematic review shows that TMS helps to improve Modified Ashworth Scale of the patients by 0.58 with p value <0.01 [51].…”

Section: Other Therapeutic Usesmentioning

confidence: 99%

Transcranial Magnetic Stimulation, Connectome and Its Clinical Applications

Yuen¹

2023

Advances in Electroencephalography and Brain Connectome

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Transcranial magnetic stimulation is an non-invasive method of neuromodulation. It uses magnetic field to induce generation of current for cortical stimulation. It can modulate the altered equilibrium in cortical excitability by magnetic field. Though it is famous for its application in treating psychiatric diseases, it has many other applications. Since its introduction in 1985, it has been used to check the integrity of motor pathway. With more understanding of the technique, it has been started to be used to check the integrity of other brain connections like speech and vision. Due to its ability of neuromodulation, it has also been used in cortical mapping in neurosurgery and neurological function rehabilitation.

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Section: Other Therapeutic Usesmentioning

confidence: 99%

Transcranial Magnetic Stimulation, Connectome and Its Clinical Applications

Yuen¹

2023

Advances in Electroencephalography and Brain Connectome

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“…The potential therapeutic effect of repetitive TMS (rTMS) and transcranial direct current stimulation (tDCS) has been explored in patients with spasticity. A recent meta-analysis showed moderate evidence that low-frequency rTMS and anodal tDCS may be effective in poststroke spasticity [81]. Trans-spinal direct current stimulation was reported to induce long-term reduction in spasticity, depression in spinal reflexes, and improved ground and skill locomotion in animal models, but evidence in humans still lacks [82].…”

Section: Noninvasive Brain and Spinal Modulation And Other Nonpharmac...mentioning

confidence: 99%

Spasticity following brain and spinal cord injury: assessment and treatment

Tamburin

Filippetti

Mantovani

et al. 2022

Current Opinion in Neurology

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Purpose of reviewSpasticity is a common sequela of brain and spinal cord injury and contributes to disability, reduces quality of life, and increases economic burden. Spasticity is still incompletely recognized and undertreated. We will provide an overview of recent published data on the definition, assessment, and prediction, therapeutic advances, with a focus on promising new approaches, and telemedicine applications for spasticity.Recent findingsTwo new definitions of spasticity have been recently proposed, but operational criteria should be developed, and test–retest and inter-rater reliability should be explored. Cannabinoids proved to be effective in spasticity in multiple sclerosis, but evidence in other types of spasticity is lacking. Botulinum neurotoxin injection is the first-line therapy for focal spasticity, and recent literature focused on optimizing its efficacy. Several pharmacological, interventional, and nonpharmacological therapeutic approaches for spasticity have been explored but low-quality evidence impedes solid conclusions on their efficacy. The recent COVID-19 pandemic yielded guidelines/recommendations for the use of telemedicine in spasticity.SummaryDespite the frequency of spasticity, robust diagnostic criteria and reliable assessment scales are required. High-quality studies are needed to support the efficacy of current treatments for spasticity. Future studies should explore telemedicine tools for spasticity assessment and treatment.

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“…25,26 Wang et al showed evidence that NIBS decreases spasticity in stroke survivors. 27 Li et al examined the impacts of NIBS on cognition and motor functions in PwMS; two studies in terms of spasticity were included. 28 Two reviews by Zhang et al and Kan et al aimed to evaluate effects of NIBS on neurological symptoms in PwMS.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive brain stimulation for spasticity rehabilitation in multiple sclerosis: A systematic review of randomized controlled trials

Alashram,

Janada,

Ghrear

2023

PM&R

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ObjectivesTo investigate the effects of noninvasive brain stimulation (NIBS) on spasticity in people with multiple sclerosis (PwMS).Literature surveyWe searched PubMed, SCOPUS, MEDLINE, REHABDATA, PEDro, CINAHL, AMED, and Web of Science until December 2022.MethodologyStudies were selected if they included PwMS, using transcranial direct current stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS) as a main intervention, and the study was a randomized controlled trial (RCT) including at least one outcome measure evaluating spasticity. Two researchers individually screened the selected studies. The study's quality was assessed using the Cochrane Collaborations tool. The researchers decided that the meta‐analysis was not possible because the treatment interventions varied among the selected studies.SynthesisIn total, 147 studies were reviewed. Of them, nine studies met the eligibility criteria and included 193 PwMS (mean age = 43.25), 54.4% of whom were females. Eight studies considered "high" quality and one considered "moderate" quality. Seven studies that used rTMS demonstrated a significant decrease in spasticity in PwMS after the intervention. The remaining studies that provided tDCS did not show meaningful effects.ConclusionsThe evidence for the influences of rTMS on spasticity in PwMS is promising. The evidence for the impact of tDCS on spasticity in PwMS was limited. Further RCTs with long‐term follow‐ups are encouraged.This article is protected by copyright. All rights reserved.

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Effects of Non-Invasive Brain Stimulation on Post-Stroke Spasticity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cited by 18 publications

References 56 publications

Transcranial Magnetic Stimulation, Connectome and Its Clinical Applications

Transcranial Magnetic Stimulation, Connectome and Its Clinical Applications

Spasticity following brain and spinal cord injury: assessment and treatment

Noninvasive brain stimulation for spasticity rehabilitation in multiple sclerosis: A systematic review of randomized controlled trials

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