Effect of Low-Frequency rTMS on Aphasia in Stroke Patients: A Meta-Analysis of Randomized Controlled Trials
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{"title"=>"Effect of Low-Frequency rTMS on Aphasia in Stroke Patients: A Meta-Analysis of Randomized Controlled Trials", "type"=>"journal", "authors"=>[{"first_name"=>"Cai-Li", "last_name"=>"Ren"}, {"first_name"=>"Guo-Fu", "last_name"=>"Zhang"}, {"first_name"=>"Nan", "last_name"=>"Xia"}, {"first_name"=>"Chun-Hui", "last_name"=>"Jin"}, {"first_name"=>"Xiu-Hua", "last_name"=>"Zhang"}, {"first_name"=>"Jian-Feng", "last_name"=>"Hao"}, {"first_name"=>"Hong-Bo", "last_name"=>"Guan"}, {"first_name"=>"Hong", "last_name"=>"Tang"}, {"first_name"=>"Jian-An", "last_name"=>"Li"}, {"first_name"=>"De-Liang", "last_name"=>"Cai"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"1932-6203", "doi"=>"10.1371/journal.pone.0102557", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "pmid"=>"25036386"}, "id"=>"f4b4b3ea-aa3c-3ef0-8143-65ae9ada0f67", "abstract"=>"BACKGROUND: Small clinical trials have reported that low-frequency repetitive transcranial magnetic stimulation (rTMS) might improve language recovery in patients with aphasia after stroke. However, no systematic reviews or meta-analyses studies have investigated the effect of rTMS on aphasia. The objective of this study was to perform a meta-analysis of studies that explored the effects of low-frequency rTMS on aphasia in stroke patients.\\n\\nMETHODS: We searched PubMed, CENTRAL, Embase, CINAHL, ScienceDirect, and Journals@Ovid for randomized controlled trials published between January 1965 and October 2013 using the keywords \"aphasia OR language disorders OR anomia OR linguistic disorders AND repetitive transcranial magnetic stimulation OR rTMS\". We used fixed- and random-effects models to estimate the standardized mean difference (SMD) and a 95% CI for the language outcomes.\\n\\nRESULTS: Seven eligible studies involving 160 stroke patients were identified in this meta-analysis. A significant effect size of 1.26 was found for the language outcome severity of impairment (95% CI = 0.80 to 1.71) without heterogeneity (I2 = 0%, P = 0.44). Further analyses demonstrated prominent effects for the naming subtest (SMD = 0.52, 95% CI = 0.18 to 0.87), repetition (SMD = 0.54, 95% CI = 0.16 to 0.92), writing (SMD = 0.70, 95% CI = 0.19 to 1.22), and comprehension (the Token test: SMD = 0.58, 95% CI = 0.07 to 1.09) without heterogeneity (I2 = 0%). The SMD of AAT and BDAE comprehension subtests was 0.32 (95% CI = -0.08 to 0.72) with moderate heterogeneity (I2 = 32%,P = 0.22). The effect size did not change significantly even when any one trial was eliminated. None of the patients from the 7 included articles reported adverse effects from rTMS.\\n\\nCONCLUSIONS: Low-frequency rTMS with a 90% resting motor threshold that targets the triangular part of the right inferior frontal gyrus (IFG) has a positive effect on language recovery in patients with aphasia following stroke. Further well-designed studies with larger populations are required to ascertain the long-term effects of rTMS in aphasia treatment.", "link"=>"http://www.mendeley.com/research/effect-lowfrequency-rtms-aphasia-stroke-patients-metaanalysis-randomized-controlled-trials-2", "reader_count"=>57, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Student > Doctoral Student"=>2, "Researcher"=>11, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>5, "Student > Master"=>12, "Other"=>4, "Student > Bachelor"=>9, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Student > Doctoral Student"=>2, "Researcher"=>11, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>5, "Student > Master"=>12, "Other"=>4, "Student > Bachelor"=>9, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Nursing and Health Professions"=>2, "Agricultural and Biological Sciences"=>3, "Medicine and Dentistry"=>20, "Neuroscience"=>9, "Psychology"=>14, "Social Sciences"=>1, "Linguistics"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>20}, "Neuroscience"=>{"Neuroscience"=>9}, "Social Sciences"=>{"Social Sciences"=>1}, "Psychology"=>{"Psychology"=>14}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Linguistics"=>{"Linguistics"=>3}, "Unspecified"=>{"Unspecified"=>5}}, "reader_count_by_country"=>{"United States"=>1, "Egypt"=>1, "Italy"=>1, "United Kingdom"=>1, "Spain"=>1}, "group_count"=>4}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1600712"], "description"=>"<p>Risk of bias summary (B): overview of the authors' judgments about each risk of bias item for each included study.</p>", "links"=>[], "tags"=>["Critical care and emergency medicine", "Trauma medicine", "Neurorehabilitation and trauma", "Diagnostic medicine", "Clinical neurophysiology", "health care", "physiotherapy", "otorhinolaryngology", "Laryngology", "Speech-language pathology", "Speech therapy", "graph", "overview", "judgments", "presented", "percentages", "included"], "article_id"=>1110494, "categories"=>["Biological Sciences"], "users"=>["Cai-Li Ren", "Guo-Fu Zhang", "Nan Xia", "Chun-Hui Jin", "Xiu-Hua Zhang", "Jian-Feng Hao", "Hong-Bo Guan", "Hong Tang", "Jian-An Li", "De-Liang Cai"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0102557.g002", "stats"=>{"downloads"=>0, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risk_of_bias_graph_A_overview_of_the_authors_judgments_about_each_risk_of_bias_item_presented_as_percentages_across_all_included_studies_/1110494", "title"=>"Risk of bias graph (A): overview of the authors' judgments about each risk of bias item presented as percentages across all included studies.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-07-18 03:08:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/1600726"], "description"=>"<div><p>Background</p><p>Small clinical trials have reported that low-frequency repetitive transcranial magnetic stimulation (rTMS) might improve language recovery in patients with aphasia after stroke. However, no systematic reviews or meta-analyses studies have investigated the effect of rTMS on aphasia. The objective of this study was to perform a meta-analysis of studies that explored the effects of low-frequency rTMS on aphasia in stroke patients.</p><p>Methods</p><p>We searched PubMed, CENTRAL, Embase, CINAHL, ScienceDirect, and Journals@Ovid for randomized controlled trials published between January 1965 and October 2013 using the keywords “aphasia OR language disorders OR anomia OR linguistic disorders AND repetitive transcranial magnetic stimulation OR rTMS”. We used fixed- and random-effects models to estimate the standardized mean difference (SMD) and a 95% CI for the language outcomes.</p><p>Results</p><p>Seven eligible studies involving 160 stroke patients were identified in this meta-analysis. A significant effect size of 1.26 was found for the language outcome severity of impairment (95% CI = 0.80 to 1.71) without heterogeneity (<i>I<sup>2</sup></i> = 0%, <i>P</i> = 0.44). Further analyses demonstrated prominent effects for the naming subtest (SMD = 0.52, 95% CI = 0.18 to 0.87), repetition (SMD = 0.54, 95% CI = 0.16 to 0.92), writing (SMD = 0.70, 95% CI = 0.19 to 1.22), and comprehension (the Token test: SMD = 0.58, 95% CI = 0.07 to 1.09) without heterogeneity (<i>I<sup>2</sup></i> = 0%). The SMD of AAT and BDAE comprehension subtests was 0.32 (95% CI = −0.08 to 0.72) with moderate heterogeneity (<i>I<sup>2</sup></i> = 32%,<i>P</i> = 0.22). The effect size did not change significantly even when any one trial was eliminated. None of the patients from the 7 included articles reported adverse effects from rTMS.</p><p>Conclusions</p><p>Low-frequency rTMS with a 90% resting motor threshold that targets the triangular part of the right inferior frontal gyrus (IFG) has a positive effect on language recovery in patients with aphasia following stroke. Further well-designed studies with larger populations are required to ascertain the long-term effects of rTMS in aphasia treatment.</p></div>", "links"=>[], "tags"=>["Critical care and emergency medicine", "Trauma medicine", "Neurorehabilitation and trauma", "Diagnostic medicine", "Clinical neurophysiology", "health care", "physiotherapy", "otorhinolaryngology", "Laryngology", "Speech-language pathology", "Speech therapy", "low-frequency", "rtms", "aphasia", "meta-analysis", "randomized", "controlled"], "article_id"=>1110508, "categories"=>["Biological Sciences"], "users"=>["Cai-Li Ren", "Guo-Fu Zhang", "Nan Xia", "Chun-Hui Jin", "Xiu-Hua Zhang", "Jian-Feng Hao", "Hong-Bo Guan", "Hong Tang", "Jian-An Li", "De-Liang Cai"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0102557", "stats"=>{"downloads"=>1, "page_views"=>45, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Effect_of_Low_Frequency_rTMS_on_Aphasia_in_Stroke_Patients_A_Meta_Analysis_of_Randomized_Controlled_Trials_/1110508", "title"=>"Effect of Low-Frequency rTMS on Aphasia in Stroke Patients: A Meta-Analysis of Randomized Controlled Trials", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-07-18 03:08:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/1600723"], "description"=>"<p>Funnel plots demonstrating publication bias for the severity of impairment (A), naming (B), repetition (C), writing (D), and comprehension (E).</p>", "links"=>[], "tags"=>["Critical care and emergency medicine", "Trauma medicine", "Neurorehabilitation and trauma", "Diagnostic medicine", "Clinical neurophysiology", "health care", "physiotherapy", "otorhinolaryngology", "Laryngology", "Speech-language pathology", "Speech therapy", "demonstrating", "severity", "impairment", "naming", "repetition", "comprehension"], "article_id"=>1110505, "categories"=>["Biological Sciences"], "users"=>["Cai-Li Ren", "Guo-Fu Zhang", "Nan Xia", "Chun-Hui Jin", "Xiu-Hua Zhang", "Jian-Feng Hao", "Hong-Bo Guan", "Hong Tang", "Jian-An Li", "De-Liang Cai"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0102557.g007", "stats"=>{"downloads"=>1, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Funnel_plots_demonstrating_publication_bias_for_the_severity_of_impairment_A_naming_B_repetition_C_writing_D_and_comprehension_E_/1110505", "title"=>"Funnel plots demonstrating publication bias for the severity of impairment (A), naming (B), repetition (C), writing (D), and comprehension (E).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-07-18 03:08:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/1600720"], "description"=>"<p>Forest plot of SMD and 95% CI for the outcome of comprehension in patients received rTMS and sham rTMS.</p>", "links"=>[], "tags"=>["Critical care and emergency medicine", "Trauma medicine", "Neurorehabilitation and trauma", "Diagnostic medicine", "Clinical neurophysiology", "health care", "physiotherapy", "otorhinolaryngology", "Laryngology", "Speech-language pathology", "Speech therapy", "smd", "ci", "comprehension", "patients", "received", "rtms", "sham"], "article_id"=>1110502, "categories"=>["Biological Sciences"], "users"=>["Cai-Li Ren", "Guo-Fu Zhang", "Nan Xia", "Chun-Hui Jin", "Xiu-Hua Zhang", "Jian-Feng Hao", "Hong-Bo Guan", "Hong Tang", "Jian-An Li", "De-Liang Cai"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0102557.g006", "stats"=>{"downloads"=>2, "page_views"=>36, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Forest_plot_of_SMD_and_95_CI_for_the_outcome_of_comprehension_in_patients_received_rTMS_and_sham_rTMS_/1110502", "title"=>"Forest plot of SMD and 95% CI for the outcome of comprehension in patients received rTMS and sham rTMS.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-07-18 03:08:48"}
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