Non-invasive brain stimulation for treating visual defects: a systematic review and meta-analysis.

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY Neurological Sciences Pub Date : 2025-07-01 Epub Date: 2025-03-22 DOI:10.1007/s10072-025-08069-y

Ahmed W Abbas, Heba Aboeldahab, Mohamed Abo Zeid, Amr K Hassan, Mahmoud Diaa Hindawi, Amr Elrosasy, Safia Lorabi, Yousef Hawas, Benyameen Safwat

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Abstract

Objective: We evaluated the efficacy of applying repetitive transorbital alternating current stimulation (rTACS) to patients suffering from visual defects, especially homonymous hemianopia.

Background: Stroke or optic neuropathy would result in vision loss or Visual field defect (VFD) and homonymous hemianopia. Recently, one of the commonly used procedures to relieve VFD is non-invasive brain stimulation (NIBS).

Methods: A comprehensive search covering publications in PubMed, Embase, Cochrane, and Scopus, spanning until September 2023 was performed. Relevant Randomized controlled trials (RCTs) were selected, and their data were extracted and analyzed. Pooled mean difference (MD) was calculated for change in the high-resolution perimetry detection accuracy (HRP DA) and fixation accuracy (HRP FA), static automated perimetry foveal threshold (SAP FT), and visual acuity (VA) of near vision outcomes.

Results: We pooled in our analysis 4 RCTs. Compared to the sham group, rTACS patients had a significantly higher HRP DA (SMD = 0.35; 95% CI [0.003,0.694] P = 0.048). However, the analysis did not favor any of the compared groups in HRP FA, SAP FT, VA of near vision, and mean threshold (SMD = 0.14; 95% CI [-0.21,0.48] P = 0.43], (SMD = 0.17; 95% CI [-0.11,0.45] P = 0.23), (SMD = 0.32; 95%CI [-0.24,0.88] P = 0.26), and (SMD = 0.31; 95% CI [-0.04,0.65] P = 0.08) respectively.

Conclusions: Current evidence suggests that rTACS exhibits a promising approach in homonymous hemianopia patients, where it significantly increased HRP DA. Despite the results' failure to attain statistical significance in some outcomes, it underscores the necessity for larger RCTs with longer follow-up periods.

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非侵入性脑刺激治疗视觉缺陷：系统回顾和荟萃分析。

目的：评价重复经眶交流电刺激（rTACS）治疗视力缺陷，特别是同名性偏视的疗效。背景：脑卒中或视神经病变可导致视力丧失或视野缺损（VFD）和同义性偏盲。近年来，一种常用的治疗VFD的方法是无创脑刺激（NIBS）。方法：综合检索PubMed、Embase、Cochrane和Scopus中截止到2023年9月的出版物。选取相关随机对照试验（rct），提取数据并进行分析。计算高分辨率周边检测精度（HRP DA）和固定精度（HRP FA）、静态自动周边检测中心阈值（SAP FT）和视力（VA）近视力结果的变化的汇总平均差（MD）。结果：我们纳入了4项随机对照试验。与假手术组相比，rTACS患者HRP DA显著升高(SMD = 0.35；95% ci [0.003,0.694] p = 0.048)。然而，在HRP FA、SAP FT、近视力VA和平均阈值(SMD = 0.14；95% ci [-0.21,0.48] p = 0.43], (smd = 0.17；95% ci [-0.11,0.45] p = 0.23), (smd = 0.32；95%CI [-0.24,0.88] P = 0.26), SMD = 0.31；95% CI [-0.04,0.65] P = 0.08)。结论：目前的证据表明，rTACS在同名性偏视患者中显示出一种很有希望的方法，它可以显著提高HRP DA。尽管在一些结果中没有达到统计学意义，但它强调了进行更长随访期的大型随机对照试验的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurological Sciences 医学-临床神经学

CiteScore

6.10

自引率

3.00%

发文量

743

审稿时长

4 months

期刊介绍： Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.