Unlocking Therapeutic Potential: Theta Burst Stimulation on Multiple Sclerosis—A Systematic Review of Randomized Control Trials
David Lo1, Meejan Palhang1, Ahmed Gawash1, Hasan Zia1, Brandon Goodwin1, Keyur Patel1, Bradley Thompson2
1Rowan-Virtua SOM, 2Rowan University
Objective:
The specific impact of NIBS on MS symptoms remains unclear due to conflicting research findings, methodological differences, and sample size variations. This knowledge gap hinders NIBS's establishment as a definitive MS symptom management strategy, prompting our comprehensive meta-analysis to provide clarity on this matter.
Background:
Multiple Sclerosis (MS) is a prevalent autoimmune disorder affecting the central nervous system, causing significant neurological disability in young adults. Its wide range of symptoms, including motor deficits, pain, cognitive impairment, and more, is linked to neural damage. Current therapies often have limited efficacy and side effects, necessitating alternative approaches. Non-invasive brain stimulation (NIBS), such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), offers potential solutions. Among NIBS techniques, Theta Burst Stimulation (TBS) is notable for its ability to modulate cortical activity.
Design/Methods:
The study conducted systematic searches in databases, using specific MeSH terms. The study selection process involved a two-tiered screening mechanism, beginning with a scrutiny of titles and abstracts, followed by a full-text review for selected articles. Data extraction was conducted by thoroughly reviewing each research article and systematically recording the relevant information using a standardized data extraction form.
Results:
Five randomized controlled trials involving 117 individuals with relapsing-remitting (RR) or secondary progressive (SP) MS, various forms of TBS were applied. Notably, TBS interventions led to significant reductions in spasticity, fatigue, and pain, with c-iTBS combined with vestibular rehabilitation showing additional improvements in vestibular ocular reflexes, gait, and balance. While specific protocols varied among the studies, collectively, the results suggest promise for TBS.
Conclusions:
The findings suggest that TBS may hold promise in addressing specific MS symptoms, notably fatigue and spasticity. The observed reduction in fatigue levels and improvements in spasticity following TBS interventions are encouraging developments. Future research should include a more diverse participant pool to explore TBS effects across different MS subtypes.