The effect of theta-burst stimulation on unilateral spatial neglect following stroke: a systematic review.

Abstract:

OBJECTIVE::To evaluate the effectiveness of theta-burst stimulation for the treatment of stroke-induced unilateral spatial neglect. DATA SOURCES::A systematic literature search was conducted from the inception of each database to 30 June 2018 using CINAHL, EMBASE, PubMed, PsycINFO, and Scopus. REVIEW METHODS::Articles were included if theta-burst stimulation was used to treat neglect following a stroke. The additional a priori inclusion criteria were as follows: (1) ⩾3 adult (⩾18 years) participants, (2) ⩾50% stroke population, and (3) peer-reviewed journal articles published in English. Extracted data included study and treatment characteristics, results, and adverse events. RESULTS::Nine studies met the inclusion criteria, generating a total of 148 participants. Eight studies evaluated a continuous stimulation protocol and one study investigated an intermittent stimulation protocol. Overall, both protocols significantly improved neglect severity when compared against placebo or active controls ( P < 0.05). Adding smooth pursuit training to theta-burst stimulation did not improve neglect relative to when the stimulation was delivered alone ( P > 0.05). There was inconsistent reporting of neglect terminology, outcome measures, and adverse events. The treatment characteristics were heterogeneous among the trials. CONCLUSION::This systematic review found that theta-burst stimulation seems to improve post-stroke unilateral spatial neglect, but because the evidence is limited to a few small studies with varied and inconsistent protocols and use of terminology, no firm conclusion on effectiveness can be drawn.

journal_name

Clin Rehabil

journal_title

Clinical rehabilitation

authors

Cotoi A,Mirkowski M,Iruthayarajah J,Anderson R,Teasell R

doi

10.1177/0269215518804018

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

183-194

issue

2

eissn

0269-2155

issn

1477-0873

journal_volume

33

pub_type

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