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Theta-burst stimulation as a therapeutic tool in neurological pathology: a systematic review

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Abstract

TBS (theta-burst stimulation) is a novel therapeutic approach in a wide range of neurological diseases. The present systematic review aims to identify the various protocols used in the last years, to assess study quality and to offer a general overview of the current state of the literature. The systematic review was conducted according to the Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines. We applied the following inclusion criteria: (1) population over 18 years old with diagnosed neurological disorders, (2) patients treated with sessions of theta-burst stimulation, (3) randomized-controlled clinical trials, (4) articles in the English language, and (5) studies that report response and score reduction on a validated scale of the investigated disorder or remission rates. We included in the final analysis 56 randomized controlled trials focusing on different neurological pathologies (stroke, Parkinson`s disease, multiple sclerosis, tinnitus, dystonia, chronic pain, essential tremor and tic disorder), and we extracted data regarding study design, groups and comparators, sample sizes, type of coil, stimulation parameters (frequency, number of pulses, intensity, stimulation site etc.), number of sessions, follow-up, assessment through functional connectivity and neurological scales used. We observed a great interstudy heterogenicity that leads to a difficulty in drawing plain conclusions. TBS protocols have shown promising results in improving various symptoms in patients with neurological disorders, but larger and more coherent studies, using similar stimulation protocols and evaluation scales, are needed to establish guideline recommendations.

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Authors and Affiliations

  1. RoNeuro Institute for Neurological Research and Diagnostic, Cluj Napoca, Romania

    Nicoleta Jemna, Ana Calina Zdrenghea, Georgiana Frunza, Anca Diana Demea, Gheorghe Elian Hapca, Diana Alecsandra Grad, Ioana Anamaria Muresanu, Razvan Mircea Chereches & Fior Dafin Muresanu

  2. Department of Neurosciences, Clinical County Emergency Hospital, Cluj Napoca, Romania

    Ana Calina Zdrenghea, Georgiana Frunza, Anca Diana Demea, Gheorghe Elian Hapca & Fior Dafin Muresanu

  3. Department of Public Health, Babes-Bolyai University, Cluj-Napoca, Romania

    Razvan Mircea Chereches

  4. University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj Napoca, Romania

    Fior Dafin Muresanu

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  1. Nicoleta Jemna
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Correspondence to Ana Calina Zdrenghea.

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Appendices

Appendix A

Our search strategy is: ‘theta-burst,’ the Boolean terms ‘AND,’ ‘OR,’ followed by one keyword from this list: stroke, pain, movement disorders, traumatic brain injury, multiple sclerosis, epilepsy, cognitive dysfunctions, tinnitus and disorders of consciousness.

Appendix B

Tables illustrating collected study data.

Table 1 Study data regarding TBS protocols and effects on stroke patients
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Table 2 Study data regarding TBS protocol and effects on Parkinson’s disease patients
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Table 3 Study data regarding TBS protocol and effects on tinnitus patients
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Table 4 Study data regarding TBS protocol and effects on multiple sclerosis patients
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Table 5 Study data regarding TBS protocol and effects on chronic pain patients
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Table 6 Study data regarding TBS protocol and effects on patients diagnosed with other pathologies
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Jemna, N., Zdrenghea, A.C., Frunza, G. et al. Theta-burst stimulation as a therapeutic tool in neurological pathology: a systematic review. Neurol Sci 45, 911–940 (2024). https://doi.org/10.1007/s10072-023-07144-6

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  • DOI: https://doi.org/10.1007/s10072-023-07144-6

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