Noninvasive brain stimulation for motor dysfunction after incomplete spinal cord injury: a systematic review and meta-analysis.

Abstract

We aimed to examine the effectiveness of noninvasive brain stimulation (NIBS) on motor dysfunction after incomplete spinal cord injury (iSCI). The PubMed, Embase, and Cochrane Library were searched from the inception dates to April 30, 2022. Randomized controlled trials comparing the effects of NIBS and sham stimulation on motor dysfunction in patients with iSCI were included. Two reviewers performed the data extraction and assessed study quality using Cochrane Collaboration's Tool. The primary outcomes involved upper limb function, lower limb function, spasticity, and activities of daily living. They were analyzed using meta-analysis method and the results were reported as SMD with 95% CI. 14 studies involving 225 patients were included. NIBS reduced spasticity at the end of intervention (SMD = -0.68, 95% CI = -1.32 to -0.03, P = 0.04) and one-week follow-up (SMD = -0.82, 95% CI = -1.48 to -0.16, P = 0.02), but no beneficial effect at one-month follow-up (SMD = -0.32, 95% CI = -1.06 to 0.42, P = 0.39). Additionally, NIBS also increased lower limb muscle strength at one-month follow-up (SMD = 0.69, 95% CI = 0.11 to 1.28, P = 0.02). Other main outcomes were similar between groups. NIBS can reduce spasticity, and the favorable effect can sustain for one week after intervention. Also, NIBS can increase lower limb muscle strength at one-month follow-up.