Abstract
Objective
To evaluate the effectiveness of noninvasive brain stimulation (NIBS)—repetitive transcranial
magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)—on
hemispatial neglect and performance in activities of daily living (ADL) after stroke.
Data Sources
MEDLINE (PubMed), EMBASE, Cochrane CENTRAL, Scopus, SciELO, and Physiotherapy Evidence
Database were searched from database inception to December 2016.
Data Selection
Randomized controlled trials or crossover trials focused on determining the effects
of tDCS or rTMS combined or not combined with other therapies for hemispatial neglect
after stroke.
Data Extraction
Methodological characteristics of the studies, number of participants, comparison
groups, interventions, and outcomes were extracted.
Data Synthesis
Ten trials comprising 226 participants had data that were suitable for the meta-analysis.
Meta-analysis showed that NIBS combined with other therapies significantly improves
hemispatial neglect (standardized mean difference [SMD]=–1.91; 95% confidence interval
[CI], –2.57 to –1.25; I2=71%). A sensitivity analysis showed that rTMS (SMD=–2.16; 95% CI, –3.00 to –1.33;
I2=76%) and tDCS (SMD=–1.07; 95% CI, –1.76 to –0.37; I2=0%) had positive effects on hemispatial neglect. Furthermore, both excitatory (SMD=–2.34;
95% CI, –3.56 to –1.12; I2=65%) and inhibitory (SMD=–1.69; 95% CI, –2.49 to –0.88; I2=75%) stimulations were effective.
Conclusions
This meta-analysis reveals moderate-quality evidence for the effectiveness of NIBS
protocols combined with other therapies on hemispatial neglect and performance in
ADL after stroke.
Keywords
List of abbreviations:
ADL (activities of daily living), a-tDCS (anodal tDCS), CI (confidence interval), cTBS (continuous TBS), NIBS (noninvasive brain stimulation), PEDro (Physiotherapy Evidence Database), rTMS (repetitive transcranial magnetic stimulation), SMD (standardized mean difference), TBS (theta burst stimulation), tDCS (transcranial direct current stimulation)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: August 09, 2017
Footnotes
Clinical Trial Registration No.: PROSPERO CRD42016053049.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
