Flávio Taira Kashiwagi, Regina El Dib, Huda Gomaa, Nermeen Gawish, Erica Aranha Suzumura, Taís Regina da Silva, Fernanda Cristina Winckler, Juli Thomaz de Souza, Adriana Bastos Conforto, Gustavo José Luvizutto, Rodrigo Bazan
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Studies were selected if they were controlled and noncontrolled trials examining transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and theta burst stimulation (TBS) in USN after stroke, with outcomes measured by standardized USN and functional tests.</p><p><strong>Results: </strong>Twelve RCTs (273 participants) and 4 non-RCTs (94 participants) proved eligible. We observed a benefit in overall USN measured by the line bisection test with NIBS in comparison to sham (SMD -2.35, 95% CI -3.72, -0.98; <i>p</i> = 0.0001); the rTMS yielded results that were consistent with the overall meta-analysis (SMD -2.82, 95% CI -3.66, -1.98; <i>p</i> = 0.09). The rTMS compared with sham also suggested a benefit in overall USN measured by Motor-Free Visual Perception Test at both 1 Hz (SMD 1.46, 95% CI 0.73, 2.20; <i>p</i> < 0.0001) and 10 Hz (SMD 1.19, 95% CI 0.48, 1.89; <i>p</i> = 0.54). There was also a benefit in overall USN measured by Albert's test and the line crossing test with 1 Hz rTMS compared to sham (SMD 2.04, 95% CI 1.14, 2.95; <i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>The results suggest a benefit of NIBS on overall USN, and we conclude that rTMS is more efficacious compared to sham for USN after stroke.</p>","PeriodicalId":51299,"journal":{"name":"Neural Plasticity","volume":"2018 ","pages":"1638763"},"PeriodicalIF":3.0000,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/1638763","citationCount":"30","resultStr":"{\"title\":\"Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials.\",\"authors\":\"Flávio Taira Kashiwagi, Regina El Dib, Huda Gomaa, Nermeen Gawish, Erica Aranha Suzumura, Taís Regina da Silva, Fernanda Cristina Winckler, Juli Thomaz de Souza, Adriana Bastos Conforto, Gustavo José Luvizutto, Rodrigo Bazan\",\"doi\":\"10.1155/2018/1638763\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Unilateral spatial neglect (USN) is the most frequent perceptual disorder after stroke. 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引用次数: 30
摘要
背景:单侧空间忽视(USN)是脑卒中后最常见的知觉障碍。无创脑刺激(NIBS)是一种在康复过程中用于改变皮质兴奋性和改善感知和功能能力的工具。目的:评价NIBS对脑卒中后USN的影响。方法:广泛检索至2016年7月。选择对照和非对照试验，检查经颅直流电刺激(tDCS)、重复经颅磁刺激(rTMS)和θ波爆发刺激(TBS)对卒中后USN的影响，并通过标准化USN和功能测试测量结果。结果:12项随机对照试验(273名受试者)和4项非随机对照试验(94名受试者)证明符合条件。我们观察到，与假手术相比，NIBS的线平分试验测量的总体USN有所改善(SMD -2.35, 95% CI -3.72， -0.98;P = 0.0001);rTMS得出的结果与总体荟萃分析一致(SMD -2.82, 95% CI -3.66， -1.98;P = 0.09)。与假手术相比，rTMS也表明，在1 Hz (SMD 1.46, 95% CI 0.73, 2.20;p < 0.0001)和10 Hz (SMD 1.19, 95% CI 0.48, 1.89;P = 0.54)。与假手术相比，阿尔伯特测试和1 Hz rTMS交叉线测试测量的总体USN也有益处(SMD 2.04, 95% CI 1.14, 2.95;P < 0.0001)。结论:结果表明NIBS对整体USN有好处，我们得出结论，对于卒中后USN, rTMS比假手术更有效。
Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials.
Background: Unilateral spatial neglect (USN) is the most frequent perceptual disorder after stroke. Noninvasive brain stimulation (NIBS) is a tool that has been used in the rehabilitation process to modify cortical excitability and improve perception and functional capacity.
Objective: To assess the impact of NIBS on USN after stroke.
Methods: An extensive search was conducted up to July 2016. Studies were selected if they were controlled and noncontrolled trials examining transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and theta burst stimulation (TBS) in USN after stroke, with outcomes measured by standardized USN and functional tests.
Results: Twelve RCTs (273 participants) and 4 non-RCTs (94 participants) proved eligible. We observed a benefit in overall USN measured by the line bisection test with NIBS in comparison to sham (SMD -2.35, 95% CI -3.72, -0.98; p = 0.0001); the rTMS yielded results that were consistent with the overall meta-analysis (SMD -2.82, 95% CI -3.66, -1.98; p = 0.09). The rTMS compared with sham also suggested a benefit in overall USN measured by Motor-Free Visual Perception Test at both 1 Hz (SMD 1.46, 95% CI 0.73, 2.20; p < 0.0001) and 10 Hz (SMD 1.19, 95% CI 0.48, 1.89; p = 0.54). There was also a benefit in overall USN measured by Albert's test and the line crossing test with 1 Hz rTMS compared to sham (SMD 2.04, 95% CI 1.14, 2.95; p < 0.0001).
Conclusions: The results suggest a benefit of NIBS on overall USN, and we conclude that rTMS is more efficacious compared to sham for USN after stroke.
期刊介绍：
Neural Plasticity is an international, interdisciplinary journal dedicated to the publication of articles related to all aspects of neural plasticity, with special emphasis on its functional significance as reflected in behavior and in psychopathology. Neural Plasticity publishes research and review articles from the entire range of relevant disciplines, including basic neuroscience, behavioral neuroscience, cognitive neuroscience, biological psychology, and biological psychiatry.
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