J Neurol Neurosurg Psychiatry 76:1614-1623 doi:10.1136/jnnp.2005.069849
  • Review

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

  1. F Fregni1,
  2. D K Simon2,
  3. A Wu3,
  4. A Pascual-Leone1
  1. 1Harvard Center for Noninvasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
  2. 2Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
  3. 3Department of Neurology, University of Southern California, Los Angeles, CA, USA
  1. Correspondence to:
 Felipe Fregni
 330 Brookline Ave, KS 452, Boston, MA 02215, USA;
  • Received 17 April 2005
  • Accepted 14 June 2005
  • Revised 13 June 2005


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.


  • This work was supported by a grant from the Harvard Medical School Scholars in Clinical Science Program (NIH K30 HL04095-03) to FF and K24 RR018875 to APL

  • Competing interests: none declared

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