Effects of repetitive transcranial magnetic stimulation in multiple sclerosis: A systematic review and meta-analysis

Abstract

This study aims to quantitatively evaluate and summarize the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of patients with multiple sclerosis (MS). Methods: The PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, CBM, CNKI and Wanfang databases were searched for randomized controlled trails (RCTs) from their inception through July 10, 2021. RCTs that met the inclusion and exclusion criteria were included in the study, and RevMan software was used for meta-analysis. Outcome indicators included scores on the fatigue severity scale (FSS), modified Ashworth scale (MAS) and the H/M amplitude ratio of the Soleus H reflex. When p < 0.05, the difference was considered significant. Results: A total of 10 articles were included in this study, with 8 of them in the quantitative synthesis. The metaanalysis showed that the short-term effect of rTMS treatment for the MAS was better than that of the control treatment (95% CI: − 1.27 to − 0.25, p = 0.004); and compared with the control group, the effect of rTMS treatment for the H/M ratio showed a significant effect (95% CI: − 0.12 to − 0.03, p = 0.002); while the treatment effect for the FSS was not significant (95% CI: − 4.87 to 1.28, p = 0.25). Conclusion: Our results provide preliminary evidence for the treatment of patients with MS by rTMS, especially for improving spasticity, but further research is needed to evaluate its effects on fatigue.

Repetitive transcranial magnetic stimulation for treatment of limb spasticity following multiple sclerosis: a systematic review and meta-analysis

“…Due to the limited number of studies and inconsistent follow-up period, this result should be interpreted carefully, and more evidence is required for its confirmation. In addition, no significant advantage of rTMS over sham has been found for improving fatigue, in line with Chen et al ( 26 ) meta-analysis. In stratified analyses for the outcome of spasticity, a beneficial effect was observed for HF-rTMS application for SP MS in trials with the proportion of females >50% and in trials in which rTMS application was combined with rehabilitation training.…”

Low-intensity repetitive transcranial magnetic stimulation is safe and well tolerated by people living with MS – outcomes of the phase I randomised controlled trial (TAURUS)

“…As the participant retention rate was high throughout the trial (90%–95%), it is unlikely that AEs went unreported or undetected. None of the AEs were classified as related to rTMS, suggesting that our novel rTMS protocol is safe for people with MS, consistent with safety reporting from prior studies that delivered different rTMS protocols to people with MS. 7 – 16 …”

Resting-state EEG and MEG biomarkers of pathological fatigue – A transdiagnostic systematic review

“…This would complement recent evidence for the efficacy of frequency-specific NIBS in treating fatigue ( Lefaucheur et al, 2017 ). NIBS showed promising results in MS and FMS fatigue ( Lefaucheur et al, 2017 , Ayache et al, 2022 , Chen et al, 2022 ) and was recently proposed as a treatment for long COVID ( Linnhoff et al, 2022 ).…”