REVIEW

Non-invasive brain stimulation for Parkinson’s disease: a systematic review and meta-analysis of the literature

F Fregni¹, D K Simon², A Wu³ and A Pascual-Leone¹

¹ Harvard Center for Noninvasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
² Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
³ Department of Neurology, University of Southern California, Los Angeles, CA, USA

Correspondence to:
Correspondence to:
Felipe Fregni
330 Brookline Ave, KS 452, Boston, MA 02215, USA; ffregni{at}bidmc.harvard.edu

A systematic review and meta-analysis were conducted to quantify the efficacy of transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT) for the treatment of motor dysfunction in patients with Parkinson’s disease (PD). Prospective studies which evaluated the effects of either TMS (12 studies) or ECT (five studies) on motor function in PD using the motor subscale of the Unified Parkinson’s Disease Rating Scale (UPDRS) for TMS studies and any continuous measures of motor function in PD for ECT studies were included. The pooled effect size (standardised mean difference between pre-treatment versus post-treatment means) from a random effects model was 0.62 (95% confidence interval: 0.38, 0.85) for TMS treatment and 1.68 (0.79, 2.56) for ECT treatment, and from a fixed effects model was 0.59 (0.39, 0.78) for TMS treatment and 1.55 (1.07, 2.03) for ECT treatment. TMS, across applied stimulation sites and parameters, can exert a significant, albeit modest, positive effect on the motor function of patients with PD. ECT also may exert a significant effect on motor function in PD patients.

Abbreviations: DBS, deep brain stimulation; ECT, electroconvulsive therapy; PD, Parkinson’s disease; rTMS, repetitive transcranial magnetic stimulation; SD, standard deviation; TMS, transcranial magnetic stimulation; UPDRS, Unified Parkinson’s Disease Rating Scale; 95% CI, 95% confidence interval

Keywords: electroconvulsive therapy; meta-analysis; Parkinson’s disease; transcranial magnetic stimulation

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