Effect of low-frequency rTMS on aphasia in stroke patients: a meta-analysis of randomized controlled trials.
PLoS One
; 9(7): e102557, 2014.
Article
em En
| MEDLINE
| ID: mdl-25036386
ABSTRACT
BACKGROUND:
Small clinical trials have reported that low-frequency repetitive transcranial magnetic stimulation (rTMS) might improve language recovery in patients with aphasia after stroke. However, no systematic reviews or meta-analyses studies have investigated the effect of rTMS on aphasia. The objective of this study was to perform a meta-analysis of studies that explored the effects of low-frequency rTMS on aphasia in stroke patients.METHODS:
We searched PubMed, CENTRAL, Embase, CINAHL, ScienceDirect, and Journals@Ovid for randomized controlled trials published between January 1965 and October 2013 using the keywords "aphasia OR language disorders OR anomia OR linguistic disorders AND repetitive transcranial magnetic stimulation OR rTMS". We used fixed- and random-effects models to estimate the standardized mean difference (SMD) and a 95% CI for the language outcomes.RESULTS:
Seven eligible studies involving 160 stroke patients were identified in this meta-analysis. A significant effect size of 1.26 was found for the language outcome severity of impairment (95% CIâ=â0.80 to 1.71) without heterogeneity (I2â=â0%, Pâ=â0.44). Further analyses demonstrated prominent effects for the naming subtest (SMDâ=â0.52, 95% CIâ=â0.18 to 0.87), repetition (SMDâ=â0.54, 95% CIâ=â0.16 to 0.92), writing (SMDâ=â0.70, 95% CIâ=â0.19 to 1.22), and comprehension (the Token test SMDâ=â0.58, 95% CIâ=â0.07 to 1.09) without heterogeneity (I2â=â0%). The SMD of AAT and BDAE comprehension subtests was 0.32 (95% CIâ=â-0.08 to 0.72) with moderate heterogeneity (I2â=â32%,Pâ=â0.22). The effect size did not change significantly even when any one trial was eliminated. None of the patients from the 7 included articles reported adverse effects from rTMS.CONCLUSIONS:
Low-frequency rTMS with a 90% resting motor threshold that targets the triangular part of the right inferior frontal gyrus (IFG) has a positive effect on language recovery in patients with aphasia following stroke. Further well-designed studies with larger populations are required to ascertain the long-term effects of rTMS in aphasia treatment.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Afasia
/
Ensaios Clínicos Controlados Aleatórios como Assunto
/
Infarto da Artéria Cerebral Média
/
Estimulação Magnética Transcraniana
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Systematic_reviews
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
PLoS One
Assunto da revista:
CIENCIA
/
MEDICINA
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
China