Internal medicine

Pathology

Inclusion and exclusion criteria

Transcranial magnetic stimulation

Meta-analysis

Psychiatry

Political science

Physical therapy

Randomized controlled trial

Alternative medicine

Stimulation

MEDLINE

Spasticity

Modified Ashworth scale

Multiple sclerosis

Web of science

Medicine

Physical medicine and rehabilitation

Multiple Sclerosis and Related Disorders

ObjectiveThis study aims to quantitatively evaluate and summarize the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of patients with multiple sclerosis (MS).MethodsThe PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, CBM, CNKI and Wanfang databases were searched for randomized controlled trails (RCTs) from their inception through July 10, 2021. RCTs that met the inclusion and exclusion criteria were included in the study, and RevMan software was used for meta-analysis. Outcome indicators included scores on the fatigue severity scale (FSS), modified Ashworth scale (MAS) and the H/M amplitude ratio of the Soleus H reflex. When p < 0.05, the difference was considered significant.ResultsA total of 10 articles were included in this study, with 8 of them in the quantitative synthesis. The meta-analysis showed that the short-term effect of rTMS treatment for the MAS was better than that of the control treatment (95% CI: −1.27 to −0.25, p = 0.004); and compared with the control group, the effect of rTMS treatment for the H/M ratio showed a significant effect (95% CI: −0.12 to −0.03, p = 0.002); while the treatment effect for the FSS was not significant (95% CI: −4.87 to 1.28, p = 0.25).ConclusionOur results provide preliminary evidence for the treatment of patients with MS by rTMS, especially for improving spasticity, but further research is needed to evaluate its effects on fatigue.

Effects of repetitive transcranial magnetic stimulation in multiple sclerosis: A systematic review and meta-analysis