| Objective:To evaluate the effect of repetitive transcranial magnetic stimulation(rTMS)on non-motor symptoms of Parkinson’s disease(PD).To provide a theoretical basis for the clinical application of rTMS in the treatment of non-motor symptoms of PD.Methods:Electronic databases were searched: Pub Med,Cochrane,Embase,CNKI,VIP,Wanfang,and China Biodatabase,and randomized controlled trials(RCTs)on the rTMS treatment of non-motor symptoms of PD published between March 15,2023 were screened according to the established inclusion and exclusion criteria.Controlled trials.Two researchers independently performed searches and quality assessments and extracted data from these articles.Rev Man 5.3 software was used for statistical analysis,and random effects models(REM)were used to calculate the standardized mean difference(SMD).Results:1.A total of 21 RCTs on non-motor symptoms of PD were included in this paper,with a total sample size of 1230 cases.2.Among them,8 articles were included in the study of PD with cognitive impairment,with a sample size of 489 cases,249 cases in the experimental group,and240 cases in the control group.The cognitive scores of the outcome indicators(Mo CA,MMSE)were evaluated,and the results showed that they were comparable to those in the control group.Compared with rTMS,the cognitive score improved statistically[SMD = 1.24,95%CI =(0.61,1.87)].3.Included 5 articles on the effect of stimulation frequency on the treatment of PD with depression,with a sample size of 278 cases,138 cases in the high frequency group and 140 cases in the low frequency group.The outcome index HAMD score was evaluated.The results showed that compared with the low frequency group,the high The improvement of depression score in the frequency group after treatment was not statistically significant [SMD=-0.12,95%CI=(-1.25,1.00)].4.Included 3 articles on the study of PD with anxiety,with a sample size of 150 cases,75 cases in the experimental group and 75 cases in the control group.The outcome index anxiety scores(SAS,HAMA)were evaluated.The results showed that compared with the control group,rTMS After treatment,the anxiety score improved statistically [SMD =-1.06,95%CI =(-1.63,-0.50)].5.Included 3 articles on the study of PD with pain,with a sample size of 200 cases,100 cases in the experimental group,and 100 cases in the control group.The outcome index pain score(KPPS,NRS)was evaluated.The results showed that compared with the control group,rTMS After treatment,the pain score improved statistically [SMD =-2.46,95%CI =(-4.27,-0.66)].6.Included 2 articles on the study of PD with drowsiness,with a sample size of113 cases,59 cases in the experimental group and 54 cases in the control group.The outcome index Epworth Sleepiness Scale was evaluated.The results showed that compared with the control group,drowsiness after rTMS treatment The score improvement was not statistically significant [SMD=-0.54,95%CI=(-1.34,-0.26)].Conclusion:rTMS treatment can improve the cognition,anxiety,pain and other non-motor symptoms of PD patients,but there is no significant improvement in the symptoms of PD patients with lethargy.There is no difference in the efficacy of high-frequency rTMS and low-frequency rTMS in the treatment of PD with depression. |
