Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials
Background. Unilateral spatial neglect (USN) is the most frequent perceptual disorder after stroke. Noninvasive brain stimulation (NIBS) is a tool that has been used in the rehabilitation process to modify cortical excitability and improve perception and functional capacity. Objective. To assess the...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Neural Plasticity |
| Online Access: | http://dx.doi.org/10.1155/2018/1638763 |
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| author | Flávio Taira Kashiwagi Regina El Dib Huda Gomaa Nermeen Gawish Erica Aranha Suzumura Taís Regina da Silva Fernanda Cristina Winckler Juli Thomaz de Souza Adriana Bastos Conforto Gustavo José Luvizutto Rodrigo Bazan |
| author_facet | Flávio Taira Kashiwagi Regina El Dib Huda Gomaa Nermeen Gawish Erica Aranha Suzumura Taís Regina da Silva Fernanda Cristina Winckler Juli Thomaz de Souza Adriana Bastos Conforto Gustavo José Luvizutto Rodrigo Bazan |
| author_sort | Flávio Taira Kashiwagi |
| collection | DOAJ |
| description | Background. Unilateral spatial neglect (USN) is the most frequent perceptual disorder after stroke. Noninvasive brain stimulation (NIBS) is a tool that has been used in the rehabilitation process to modify cortical excitability and improve perception and functional capacity. Objective. To assess the impact of NIBS on USN after stroke. Methods. An extensive search was conducted up to July 2016. Studies were selected if they were controlled and noncontrolled trials examining transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and theta burst stimulation (TBS) in USN after stroke, with outcomes measured by standardized USN and functional tests. Results. Twelve RCTs (273 participants) and 4 non-RCTs (94 participants) proved eligible. We observed a benefit in overall USN measured by the line bisection test with NIBS in comparison to sham (SMD −2.35, 95% CI −3.72, −0.98; p=0.0001); the rTMS yielded results that were consistent with the overall meta-analysis (SMD −2.82, 95% CI −3.66, −1.98; p=0.09). The rTMS compared with sham also suggested a benefit in overall USN measured by Motor-Free Visual Perception Test at both 1 Hz (SMD 1.46, 95% CI 0.73, 2.20; p<0.0001) and 10 Hz (SMD 1.19, 95% CI 0.48, 1.89; p=0.54). There was also a benefit in overall USN measured by Albert’s test and the line crossing test with 1 Hz rTMS compared to sham (SMD 2.04, 95% CI 1.14, 2.95; p<0.0001). Conclusions. The results suggest a benefit of NIBS on overall USN, and we conclude that rTMS is more efficacious compared to sham for USN after stroke. |
| format | Article |
| id | doaj-art-502e1fbf215d4469be8f24410111944c |
| institution | Kabale University |
| issn | 2090-5904 1687-5443 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Neural Plasticity |
| spelling | doaj-art-502e1fbf215d4469be8f24410111944c2025-02-03T05:44:13ZengWileyNeural Plasticity2090-59041687-54432018-01-01201810.1155/2018/16387631638763Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled TrialsFlávio Taira Kashiwagi0Regina El Dib1Huda Gomaa2Nermeen Gawish3Erica Aranha Suzumura4Taís Regina da Silva5Fernanda Cristina Winckler6Juli Thomaz de Souza7Adriana Bastos Conforto8Gustavo José Luvizutto9Rodrigo Bazan10Neurology Department, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, SP, BrazilScience and Technology Institute, Universidade Estadual Paulista (UNESP), São José dos Campos, SP, BrazilDepartment of Pharmacy, Tanta Chest Hospital, Tanta, EgyptDepartment of Pharmacy, Tanta Chest Hospital, Tanta, EgyptResearch Institute, Hospital do Coração (HCor), São Paulo, SP, BrazilNeurology Department, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, SP, BrazilNeurology Department, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, SP, BrazilScience and Technology Institute, Universidade Estadual Paulista (UNESP), São José dos Campos, SP, BrazilNeurostimulation Laboratory, University of São Paulo (USP), São Paulo, SP, BrazilDepartment of Applied Physical Therapy, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, BrazilNeurology Department, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, SP, BrazilBackground. Unilateral spatial neglect (USN) is the most frequent perceptual disorder after stroke. Noninvasive brain stimulation (NIBS) is a tool that has been used in the rehabilitation process to modify cortical excitability and improve perception and functional capacity. Objective. To assess the impact of NIBS on USN after stroke. Methods. An extensive search was conducted up to July 2016. Studies were selected if they were controlled and noncontrolled trials examining transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and theta burst stimulation (TBS) in USN after stroke, with outcomes measured by standardized USN and functional tests. Results. Twelve RCTs (273 participants) and 4 non-RCTs (94 participants) proved eligible. We observed a benefit in overall USN measured by the line bisection test with NIBS in comparison to sham (SMD −2.35, 95% CI −3.72, −0.98; p=0.0001); the rTMS yielded results that were consistent with the overall meta-analysis (SMD −2.82, 95% CI −3.66, −1.98; p=0.09). The rTMS compared with sham also suggested a benefit in overall USN measured by Motor-Free Visual Perception Test at both 1 Hz (SMD 1.46, 95% CI 0.73, 2.20; p<0.0001) and 10 Hz (SMD 1.19, 95% CI 0.48, 1.89; p=0.54). There was also a benefit in overall USN measured by Albert’s test and the line crossing test with 1 Hz rTMS compared to sham (SMD 2.04, 95% CI 1.14, 2.95; p<0.0001). Conclusions. The results suggest a benefit of NIBS on overall USN, and we conclude that rTMS is more efficacious compared to sham for USN after stroke.http://dx.doi.org/10.1155/2018/1638763 |
| spellingShingle | Flávio Taira Kashiwagi Regina El Dib Huda Gomaa Nermeen Gawish Erica Aranha Suzumura Taís Regina da Silva Fernanda Cristina Winckler Juli Thomaz de Souza Adriana Bastos Conforto Gustavo José Luvizutto Rodrigo Bazan Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials Neural Plasticity |
| title | Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials |
| title_full | Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials |
| title_fullStr | Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials |
| title_full_unstemmed | Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials |
| title_short | Noninvasive Brain Stimulations for Unilateral Spatial Neglect after Stroke: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Controlled Trials |
| title_sort | noninvasive brain stimulations for unilateral spatial neglect after stroke a systematic review and meta analysis of randomized and nonrandomized controlled trials |
| url | http://dx.doi.org/10.1155/2018/1638763 |
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