Repetitive transcranial magnetic stimulation (rTMS) improves motor symptoms for patients with Parkinson disease, according to a systematic review and meta-analysis of 20 sham-controlled, randomized clinical trials of rTMS comprising 470 patients.
Investigators found standardized mean differences (SMD) favoring active rTMS over sham rTMS in the reduction of motor symptoms in patients with Parkinson disease, as follows:
• high-frequency rTMS, primary motor cortex: SMD, 0.77
• low-frequency rTMS, other frontal regions: SMD, 0.50
• high-frequency rTMS, other frontal regions: SMD, 0.23
• low-frequency rTMS, primary motor cortex: SMD, 0.28
The study authors note combinations of rTMS sites, frequency, and number of rTMS pulses impact rTMS effects.
Citation: Chou YH, Hickey PT, Sundman M, Song AW, Chen NK. Effects of repetitive transcranial magnetic stimulation on motor symptoms in Parkinson disease: a systematic review and meta-analysis. JAMA Neurol. 2015. doi: 10.1001/jamaneurol.2014.4380.