经颅磁刺激治疗帕金森病的Meta分析

A meta-analysis on transcranial magnetic stimulation for Parkinson＇s disease

目的 评价经颅磁刺激（TMS）治疗帕金森病的疗效和安全性.方法 电子检索中外文数据库,辅以文献追溯检索.按磁刺激频率,将其分为高频刺激（＞1 Hz）和低频刺激（≤1 Hz）进行分别统计,用RevMan 5.0软件进行Meta分析.结果 低频、高频磁刺激治疗后,统一帕金森病评定量表（UPDRS）总分真刺激组比假刺激刺激组降低,分别为（WMD=-10.71,95%CI[-19.05,-2.37],P=0.01）和（WMD=-6.00,95%CI[-11.14,-0.86],P=0.02）,真、假刺激组差异有统计学意义.高频磁刺激组UPDRS运动评分比假刺激组降低,（WMD=-6.15,95%CI[-9.36,-2.95],P＜0.01）,真、假刺激组差异有统计学意义;低频磁刺激UPDRSⅢ运动评分、UPDRS Ⅰ精神评分、UPDRSⅡ日常生活活动评分、低频或高频治疗后the Schwab and England日常生活活动（ADL）评分真、假刺激组差异均无统计学意义.结论 TMS是一种安全有效的治疗帕金森病的方法.

Objective To systematically review findings on the effectiveness and safety of transcranial magnetic stimulation （TMS） for treating Parkinson＇s disease. Methods Foreign and Chinese databases were searched to find relevant trials. The searches were supplemented by searching the reference lists of the published trials. The studies were separated into two groups： those applying TMS at frequencies higher than 1 Hz, and those at 1 Hz or lower. Meta-analysis was performed with the aid of RevMan 5.0 software. Results Both low-frequency and highfrequency TMS can significantly reduce total scores on the Unified Parkinson＇s Disease Rating Scale （UPDRS） compared with sham stimulations. High-frequency TMS can significantly reduce UPDRS motor scores compared with sham stimulations. On the other hand, low-frequency TMS studies showed no significant overall improvement in motor scores, mental scores or in the activities of daily living （ADL） UPDRS scores. Low-frequency and high-frequency TMS studies also showed no significant overall improvement in Schwab and England ADL scores. Conclusions TMS therapy is safe and partially effective for treating Parkinson＇s disease.