[Effects of repetitive transcranial magnetic stimulation on upper limb motor function in patients with stroke: a meta analysis].

Objective: To perform a meta analysis of studies that investigated the effects of repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function in patients with stroke. Methods: We searched for related articles published before October 2015 in MEDLINE(Pubmed) (January 1966 to October 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (October 2015), EMBASE(SCOPUS) (January 1974 to October 2015), Chinese Biomedical Database (CBMDisc) (January 1978 to October 2015), China National Knowledge Infrastructure (CNKI) (January 1979 to October 2015) and Wanfang database(January 1989 to October 2015). Results: A total of nine studies with 289 patients were included in this analysis.The results showed that rTMS had a significant effect for ischemic stroke patients with upper limb motor disorder with SMD 0.43, 95% CI 0.19-0.67, P =0.000 4. Further subgroup analyses about high or low frequency rTMS demonstrated low frequency rTMS showed prominent effects for the stroke patients with SMD 0.50, 95% CI 0.14-0.85, P =0.007.Only 3 patients from the 9 studies included in this analysis reported adverse effects from rTMS. Conclusions: The meta analysis suggests that rTMS has a positive effect on motor recovery in patients with stroke, especially the low frequency rTMS may be more beneficial.The clinical application of rTMS in patients with stroke is relatively safe.Intermittent theta-burst stimulation might be a useful intervention.