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Erschienen in:
18.08.2022 | Review Article
Repetitive transcranial magnetic stimulation (rTMS) for post-stroke sleep disorders: a systematic review of randomized controlled trials
Erschienen in: Neurological Sciences | Ausgabe 12/2022
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Objective
Survivors of stroke often experience post-stroke sleep disorders (PSSDs), but pharmacotherapy risks adverse side effects. Transcranial magnetic stimulation (TMS) is potentially a nonpharmacotherapeutic option. This meta-analysis investigated the effects of rTMS to treat PSSD.
Methods
Databases were searched for randomized controlled trials (RCTs) of rTMS to treat PSSD, conducted in accordance with the PRISMA 2020 guidelines. Risk-of-bias assessments were performed using the Cochrane risk-of-bias tool. A meta-analysis of the following indexes was performed using RevMan 5.4 software: Pittsburgh sleep quality index; effective rate of sleep improvement; Hamilton Anxiety Rating Scale (for mood); and National Institute of Health Stroke Scale (NIHSS, stroke severity). Mean differences (MDs) and confidence intervals (CIs) were calculated.
Results
The meta-analysis included 17 RCTs, with 1411 patients overall. The indexes indicated that rTMS could improve the sleep quality, mood, and stroke severity of patients with PSSD: Pittsburgh sleep quality index (12 studies; MD = − 2.51, 95% CI [− 3.24, − 1.79], P < 0.00001); effective rate of sleep improvement (7 studies; MD = 4.03, 95% CI [2.43, 6.68], P < 0.0001); Hamilton Anxiety Rating Scale (2 studies; MD = − 4.05, 95% CI [− 4.77, − 3.32], P < 0.00001); and NIHSS (2 studies; MD = –2.71, 95% CI [− 3.36, − 2.06], P < 0.00001).
Conclusion
The results suggest that rTMS may have positive effects on the sleep quality, mood, and stroke severity of patients with PSSD.