Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training on Patients with Post Stroke Cognitive Impairment: A Meta-Analysis

ObjectiveTo evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training on patients with post stroke cognitive impairment (PSCI) by Meta-analysis.MethodsData were searched and retrieved from the databases of PubMed, Embase, The Cochrane Library, Web...

Full description

Saved in:
Bibliographic Details
Main Authors: LIU Changxing, GUO Xinyi, CHANG Xiang
Format: Article
Language:English
Published: Editorial Office of Rehabilitation Medicine 2024-04-01
Series:康复学报
Subjects:
Online Access:http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2024.02012
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841536860178874368
author LIU Changxing
GUO Xinyi
CHANG Xiang
author_facet LIU Changxing
GUO Xinyi
CHANG Xiang
author_sort LIU Changxing
collection DOAJ
description ObjectiveTo evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training on patients with post stroke cognitive impairment (PSCI) by Meta-analysis.MethodsData were searched and retrieved from the databases of PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Science and Technology Periodical Database (VIP). The randomized controlled trials (RCTs) of rTMS combined with cognitive training for the treatment of patients with PSCI were included, and the retrieval time was from database inception to June 2023. The primary outcome measures included Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), activities of daily living (ADL) scale and Rivermead behavioural memory test (RBMT). The quality of the literature was assessed by two investigators using the Cochrane risk of bias assessment tool, and Meta-analysis was performed using RevMan 5.3 software. Enumeration data were expressed as odds ratio (OR) or relative risk ratio (RR). Measurement data were expressed as mean difference (MD) or standardized mean difference (SMD), with 95% confidence interval (CI). The heterogeneity was determined according to the <italic>P</italic> value and <italic>I</italic><sup>2</sup> value. If <italic>P</italic>≥0.10 and <italic>I</italic><sup>2</sup>≤50%, a fixed effects model would be used, and if <italic>P</italic>&lt;0.10 and <italic>I</italic><sup>2</sup>&gt;50%, a random effects model would be used.ResultsA total of 23 RCTs with 1 788 patients were included, 895 patients in the control group and 893 patients in the experimental group. (1) MoCA scores: subgroup analyses by different treatments in the control group showed that MoCA scores in the experimental group were significantly higher than those in the control group [<italic>MD</italic>=1.78, 95% <italic>CI </italic>(1.18, 2.38), <italic>P</italic>&lt;0.000 1; <italic>MD</italic>=3.30, 95% <italic>CI </italic>(3.01,3.58), <italic>P</italic>&lt;0.000 01]; subgroup analyses by stimulation frequency showed that MoCA scores in the experimental group were significantly higher than those in the control group [<italic>MD</italic>=3.49, 95% <italic>CI</italic> (3.40, 3.57), <italic>P</italic>&lt;0.000 01; <italic>MD</italic>=3.16, 95% <italic>CI</italic> (2.79, 3.53), <italic>P</italic>&lt;0.000 01]. (2) MMSE score: compared with the control group, MMSE score in the experimental group was higher [<italic>MD</italic>=2.14, 95% <italic>CI</italic> (1.14, 3.15), <italic>P</italic>&lt;0.000 1; <italic>MD</italic>=3.16, 95% <italic>CI</italic> (2.71, 3.60), <italic>P</italic>&lt;0.000 01]. (3) ADL score: compared with the control group, ADL score in the experimental group was higher [<italic>MD</italic>=10.78, 95% <italic>CI</italic> (9.18, 12.38), <italic>P</italic>&lt;0.000 01; <italic>MD</italic>=8.23, 95% <italic>CI</italic> (7.04, 9.41), <italic>P</italic>&lt;0.000 01]. (4) RBMT score: compared with the control group, RBMT score in the experimental group was higher [<italic>MD</italic>=2.00, 95% <italic>CI</italic> (1.37, 2.63), <italic>P</italic>&lt;0.000 01].ConclusionrTMS combined with cognitive training can improve cognitive function, intelligence state, behavioral memory ability and activities of daily living of stroke patients, which is recommended for clinical application.
format Article
id doaj-art-3584873778304eab946370be948b5651
institution Kabale University
issn 2096-0328
language English
publishDate 2024-04-01
publisher Editorial Office of Rehabilitation Medicine
record_format Article
series 康复学报
spelling doaj-art-3584873778304eab946370be948b56512025-01-14T10:08:47ZengEditorial Office of Rehabilitation Medicine康复学报2096-03282024-04-013417618555742569Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training on Patients with Post Stroke Cognitive Impairment: A Meta-AnalysisLIU ChangxingGUO XinyiCHANG XiangObjectiveTo evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training on patients with post stroke cognitive impairment (PSCI) by Meta-analysis.MethodsData were searched and retrieved from the databases of PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Science and Technology Periodical Database (VIP). The randomized controlled trials (RCTs) of rTMS combined with cognitive training for the treatment of patients with PSCI were included, and the retrieval time was from database inception to June 2023. The primary outcome measures included Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), activities of daily living (ADL) scale and Rivermead behavioural memory test (RBMT). The quality of the literature was assessed by two investigators using the Cochrane risk of bias assessment tool, and Meta-analysis was performed using RevMan 5.3 software. Enumeration data were expressed as odds ratio (OR) or relative risk ratio (RR). Measurement data were expressed as mean difference (MD) or standardized mean difference (SMD), with 95% confidence interval (CI). The heterogeneity was determined according to the <italic>P</italic> value and <italic>I</italic><sup>2</sup> value. If <italic>P</italic>≥0.10 and <italic>I</italic><sup>2</sup>≤50%, a fixed effects model would be used, and if <italic>P</italic>&lt;0.10 and <italic>I</italic><sup>2</sup>&gt;50%, a random effects model would be used.ResultsA total of 23 RCTs with 1 788 patients were included, 895 patients in the control group and 893 patients in the experimental group. (1) MoCA scores: subgroup analyses by different treatments in the control group showed that MoCA scores in the experimental group were significantly higher than those in the control group [<italic>MD</italic>=1.78, 95% <italic>CI </italic>(1.18, 2.38), <italic>P</italic>&lt;0.000 1; <italic>MD</italic>=3.30, 95% <italic>CI </italic>(3.01,3.58), <italic>P</italic>&lt;0.000 01]; subgroup analyses by stimulation frequency showed that MoCA scores in the experimental group were significantly higher than those in the control group [<italic>MD</italic>=3.49, 95% <italic>CI</italic> (3.40, 3.57), <italic>P</italic>&lt;0.000 01; <italic>MD</italic>=3.16, 95% <italic>CI</italic> (2.79, 3.53), <italic>P</italic>&lt;0.000 01]. (2) MMSE score: compared with the control group, MMSE score in the experimental group was higher [<italic>MD</italic>=2.14, 95% <italic>CI</italic> (1.14, 3.15), <italic>P</italic>&lt;0.000 1; <italic>MD</italic>=3.16, 95% <italic>CI</italic> (2.71, 3.60), <italic>P</italic>&lt;0.000 01]. (3) ADL score: compared with the control group, ADL score in the experimental group was higher [<italic>MD</italic>=10.78, 95% <italic>CI</italic> (9.18, 12.38), <italic>P</italic>&lt;0.000 01; <italic>MD</italic>=8.23, 95% <italic>CI</italic> (7.04, 9.41), <italic>P</italic>&lt;0.000 01]. (4) RBMT score: compared with the control group, RBMT score in the experimental group was higher [<italic>MD</italic>=2.00, 95% <italic>CI</italic> (1.37, 2.63), <italic>P</italic>&lt;0.000 01].ConclusionrTMS combined with cognitive training can improve cognitive function, intelligence state, behavioral memory ability and activities of daily living of stroke patients, which is recommended for clinical application.http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2024.02012post stroke cognitive impairmentrepetitive transcranial magnetic stimulationcognitive trainingcognitive functionactivities of daily livingMeta-analysis
spellingShingle LIU Changxing
GUO Xinyi
CHANG Xiang
Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training on Patients with Post Stroke Cognitive Impairment: A Meta-Analysis
康复学报
post stroke cognitive impairment
repetitive transcranial magnetic stimulation
cognitive training
cognitive function
activities of daily living
Meta-analysis
title Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training on Patients with Post Stroke Cognitive Impairment: A Meta-Analysis
title_full Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training on Patients with Post Stroke Cognitive Impairment: A Meta-Analysis
title_fullStr Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training on Patients with Post Stroke Cognitive Impairment: A Meta-Analysis
title_full_unstemmed Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training on Patients with Post Stroke Cognitive Impairment: A Meta-Analysis
title_short Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training on Patients with Post Stroke Cognitive Impairment: A Meta-Analysis
title_sort clinical efficacy of repetitive transcranial magnetic stimulation combined with cognitive training on patients with post stroke cognitive impairment a meta analysis
topic post stroke cognitive impairment
repetitive transcranial magnetic stimulation
cognitive training
cognitive function
activities of daily living
Meta-analysis
url http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2024.02012
work_keys_str_mv AT liuchangxing clinicalefficacyofrepetitivetranscranialmagneticstimulationcombinedwithcognitivetrainingonpatientswithpoststrokecognitiveimpairmentametaanalysis
AT guoxinyi clinicalefficacyofrepetitivetranscranialmagneticstimulationcombinedwithcognitivetrainingonpatientswithpoststrokecognitiveimpairmentametaanalysis
AT changxiang clinicalefficacyofrepetitivetranscranialmagneticstimulationcombinedwithcognitivetrainingonpatientswithpoststrokecognitiveimpairmentametaanalysis