PTOtherNeuroRehabilitation2021

Multisite non-invasive brain stimulation in Parkinson's disease: A scoping review.

Camila Beatriz da Silva Machado, Letícia Maria da Silva, Alessandra Feitosa Gonçalves and 5 others

PMID 34776426

WHAT IT FOUND

Multisite rTMS, tDCS, or combined rTMS plus tDCS in Parkinson's disease has not shown clear benefit for both movement and thinking.

Protocols and outcomes varied widely, and evidence is insufficient to change therapy.

Key findings

0112 articles met inclusion criteria.

02Effects were inconsistent: some trials reported motor benefits, some reported mood or blood inflammatory marker changes, and some showed no superiority for any outcome.

03The review concluded there is insufficient evidence that multisite NIBS improves motor and cognitive aspects at the same time.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

This is a scoping review, so it summarizes what studies exist rather than combining their results into an overall answer. The review included 12 articles, with 387 patients in total, so the evidence base is small. Stimulation targets, coil or electrode settings, session numbers, and outcome tests varied widely across studies. Only 5 studies reported a sample-size calculation, and none gave enough information about whether the participants represented the wider Parkinson's population. Medication status was not assessed in both on and off states in most studies, which can affect brain stimulation response. Some included studies were open-label or before-after designs, so they cannot establish efficacy.

Declared interests

The authors declared no potential conflicts of interest.

The easy way to misread this

Do not read individual trial improvements as proof that multisite brain stimulation works for Parkinson's disease. The review found inconsistent results and concluded there is insufficient evidence to determine if it improves both movement and thinking.

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