Journal CME, March 2024: Noninvasive brain stimulation for spasticity rehabilitation in multiple sclerosis: A systematic review of randomized controlled trials-PM R - 2023 - Alashram - Noninvasive brain stimulation for spasticity

PM R - 2023 - Alashram - Noninvasive brain stimulation for spasticity

Pdf Summary

The systematic review investigates the effects of noninvasive brain stimulation (NIBS) on spasticity in individuals with multiple sclerosis (MS). The study reviewed 147 studies and included nine randomized controlled trials (RCTs) that met the eligibility criteria, involving 193 individuals with MS. The results showed that repetitive transcranial magnetic stimulation (rTMS) demonstrated a significant decrease in spasticity in individuals with MS, while transcranial direct current stimulation (tDCS) did not show significant effects. The quality of evidence for rTMS on spasticity was considered promising, while tDCS had limited evidence. The studies highlighted the importance of further RCTs with long-term follow-ups to better understand the impacts of NIBS on spasticity in MS.<br /><br />Spasticity, a common symptom in MS affecting about 80% of individuals, can significantly impact functions like walking, balance, and mobility. Current treatments often have side effects, leading to an increased focus on nonpharmacological interventions like NIBS. rTMS uses magnetic currents to alter neural excitability, while tDCS delivers electrical currents to stimulate neurons. The studies varied in NIBS parameters and interventions, making it challenging to define the most effective protocol. The review suggests that combining NIBS with other therapies may enhance outcomes and emphasizes the need for larger RCTs to establish optimal NIBS protocols for spasticity in MS.

Keywords

noninvasive brain stimulation

NIBS

spasticity

multiple sclerosis

repetitive transcranial magnetic stimulation

rTMS

transcranial direct current stimulation

tDCS

randomized controlled trials