Non-Invasive Brain Stimulation Improves Paretic Limb Force Production: A Systematic Review and Meta-Analysis

被引:62
作者
Kang, Nyeonju [1 ,2 ]
Summers, Jeffery J. [3 ,4 ]
Cauraugh, James H. [2 ]
机构
[1] Univ Florida, Lab Rehabil Neurosci, Gainesville, FL 32611 USA
[2] Univ Florida, Motor Behav Lab, Gainesville, FL 32611 USA
[3] Univ Tasmania, Human Motor Control Lab, Hobart, Tas, Australia
[4] Liverpool John Moores Univ, Res Inst Sport & Exercise Sci, Liverpool, Merseyside, England
关键词
Meta-analysis; Systematic review; Transcranial direct current stimulation (tDCS); Repetitive transcranial magnetic stimulation (rTMS); Stroke Force production; TRANSCRANIAL MAGNETIC STIMULATION; MOTOR FUNCTION RECOVERY; STROKE REHABILITATION; HAND; CORTEX; TDCS; EXCITABILITY; HEMIPARESIS; POSTSTROKE; PLASTICITY;
D O I
10.1016/j.brs.2016.05.005
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
Background: Non-invasive brain stimulation (NIBS) facilitates motor improvements post stroke. Transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) are representative NIBS techniques frequently used in stroke motor rehabilitation. Our primary question is: Do these two techniques improve force production capability in paretic limbs? Objective: The current systematic review and meta-analysis investigated the effects of tDCS and rTMS on paretic limb force production in stroke survivors. Methods: Our comprehensive search identified 23 studies that reported changes in force production following tDCS or rTMS interventions. Each used random assignment and a sham control group. The 23 qualified studies in our meta-analysis generated 29 comparisons: 14 tDCS and 15 rTMS comparisons. Results: Random effects models indicated improvements in paretic limb force after tDCS and rTMS rehabilitation. We found positive effects on force production in the two sets of stimulation protocols: (a) increasing cortical activity in the ipsilesional hemisphere and (b) decreasing cortical activity in the contralesional hemisphere. Moreover, across acute, subacute, and chronic phases, tDCS and rTMS improved force production. Conclusion: Cumulative meta-analytic results revealed that tDCS and rTMS rehabilitation protocols successfully improved paretic limb force production capabilities. (C) 2016 Elsevier Inc. All rights reserved.
引用
收藏
页码:662 / 670
页数:9
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