Efficacy of Repetitive Transcranial Magnetic Stimulation Over the Supplementary Motor Area on Motor Function in Parkinson's Disease: A Meta-analysis.

Abstract

The objective of this study was to assess the effect of repetitive transcranial magnetic stimulation on the supplementary motor area in motor function in Parkinson's disease patients. Databases searched included five databases from October 7, 2022, to January 4, 2023. The Cochrane Bias Risk Assessment Tool was used for quality assessment. Standardized mean differences were calculated using a random-effects model. Outcome measure is the motor function examination of the motor part of Unified Parkinson's Disease Rating Scale. Seven studies totaling 374 patients were included. Meta-analysis showed that stimulation of supplementary motor area significantly improved motor function in Parkinson's disease patients compared with sham stimulation (standardized mean differences = -1.24; 95% CI, -2.24 to -0.24; P = 0.02; I2 = 93%). Stimulation of the same target (supplementary motor area) subgroup analysis showed that high-frequency repetitive transcranial magnetic stimulation is more effective than low-frequency repetitive transcranial magnetic stimulation in improving motor function in Parkinson's disease (standardized mean differences = -1.39; 95% CI, -2.21 to -0.57; P = 0.04; I2 = 77.2%). Overall, repetitive transcranial magnetic stimulation over supplementary motor area had a statistically significant improvement in motor function in Parkinson's disease patients, and high-frequency repetitive transcranial magnetic stimulation is statistically significantly more effective than low-frequency repetitive transcranial magnetic stimulation.