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Efficacy of Cerebellar Transcranial Magnetic Stimulation for Post-stroke Balance and Limb Motor Function Impairments: Meta-analyses of Random Controlled Trials and Resting-State fMRI Studies

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Abstract

This study aimed to investigate the potential therapeutic effects of cerebellar transcranial magnetic stimulation (TMS) on balance and limb motor impairments in stroke patients. A meta-analysis of randomized controlled trials was conducted to assess the effects of cerebellar TMS on balance and motor impairments in stroke patients. Additionally, an activation likelihood estimation (ALE) meta-analysis was performed on resting-state functional magnetic resonance imaging (fMRI) studies to compare spontaneous neural activity differences between stroke patients and healthy controls using measures including the amplitude of low frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo). The analysis included 10 cerebellar TMS studies and 18 fMRI studies. Cerebellar TMS treatment demonstrated significant improvements in the Berg Balance Scale score (p < 0.0001) and the Fugl-Meyer Assessment lower extremity score (p < 0.0001) compared to the control group in stroke patients. Additionally, spontaneous neural activity alterations were identified in motor-related regions after stroke, including the precentral gyrus, putamen, thalamus, and paracentral lobule. Cerebellar TMS shows promise as a therapeutic intervention to enhance balance and lower limb motor function in stroke patients. It is easy for clinical application and addresses the limitations of insufficient direct stimulation depth on the leg area of the cortex. However, further research combining neuroimaging outcomes with clinical measurements is necessary to validate these findings.

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Data Availability

The data generated in this study are available from the corresponding author via email.

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Funding

This work is supported by the Department of Science and Technology of Sichuan Province (No. 2022NSFSC0808).

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Authors and Affiliations

  1. Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, 610041, China

    Yuheng Zeng, Zujuan Ye & Jue Wang

  2. Department of Genome Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan

    Wanxin Zheng

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  2. Zujuan Ye
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  3. Wanxin Zheng
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  4. Jue Wang
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Contributions

Yuheng Zeng and Jue Wang designed the study. Yuheng Zeng and Wanxin Zheng conducted the literature search and extracted the information. Yuheng Zeng and Zujuan Ye analyzed the data. Yuheng Zeng drafted the manuscript. All the authors reviewed and approved the manuscript.

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Correspondence to Yuheng Zeng.

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Zeng, Y., Ye, Z., Zheng, W. et al. Efficacy of Cerebellar Transcranial Magnetic Stimulation for Post-stroke Balance and Limb Motor Function Impairments: Meta-analyses of Random Controlled Trials and Resting-State fMRI Studies. Cerebellum (2024). https://doi.org/10.1007/s12311-024-01660-7

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