The effect of theta-burst stimulation on unilateral spatial neglect following stroke: a systematic review

Abstract

Objective: To evaluate the effectiveness of theta-burst stimulation for the treatment of stroke-induced unilateral spatial neglect. Data sources: A systematic literature search was conducted from the inception of each database to 30 June 2018 using CINAHL, EMBASE, PubMed, PsycINFO, and Scopus. Review methods: Articles were included if theta-burst stimulation was used to treat neglect following a stroke. The additional a priori inclusion criteria were as follows: (1) ⩾3 adult (⩾18 years) participants, (2) ⩾50% stroke population, and (3) peer-reviewed journal articles published in English. Extracted data included study and treatment characteristics, results, and adverse events. Results: Nine studies met the inclusion criteria, generating a total of 148 participants. Eight studies evaluated a continuous stimulation protocol and one study investigated an intermittent stimulation protocol. Overall, both protocols significantly improved neglect severity when compared against placebo or active controls (P < 0.05). Adding smooth pursuit training to theta-burst stimulation did not improve neglect relative to when the stimulation was delivered alone (P > 0.05). There was inconsistent reporting of neglect terminology, outcome measures, and adverse events. The treatment characteristics were heterogeneous among the trials. Conclusion: This systematic review found that theta-burst stimulation seems to improve post-stroke unilateral spatial neglect, but because the evidence is limited to a few small studies with varied and inconsistent protocols and use of terminology, no firm conclusion on effectiveness can be drawn.

Brazilian practice guidelines for stroke rehabilitation: Part II

“… 134 Repetitive transcranial magnetic stimulation in the posterior parietal cortex, and theta-burst stimulation, improved USN after stroke. 135 Very low-quality evidence suggested that tDCS has a beneficial effect in improving USN after stroke. 136 …”

The Immediate Effects of Intermittent Theta Burst Stimulation of the Cerebellar Vermis on Cerebral Cortical Excitability During a Balance Task in Healthy Individuals: A Pilot Study

“…There are a number of NIBS studies on the cerebellar hemisphere; however, studies of cerebellar vermis are relatively rare. Intermittent theta burst stimulation (iTBS), a type of repetitive transcranial magnetic stimulation (rTMS), which serves as a NIBS method, has been proved to have the positive effects on neuroplasticity and central nervous system excitability ( Cotoi et al, 2019 ; Katagiri et al, 2020 ). It exhibits long lasting effects compared with traditional TMS with shorter stimulation period than traditional TMS ( Kim et al, 2015 ; Hurtado-Puerto et al, 2020 ).…”

Noninvasive Brain Stimulation and Noninvasive Peripheral Stimulation for Neglect Syndrome Following Acquired Brain Injury

“…Although the authors found mild evidence of the efficacy of rTMS for the treatment of neglect, no significant positive effect was found regarding tDCS. Furthermore, recently one systematic review on TBS and neglect (111) found a positive effect on the symptoms although a strong heterogeneity of protocols and assessment was found. As stated, only cerebrovascular disease patients were included; the results were biased by the small number of patients and strong heterogeneity of the protocol of NIBS.…”