Evidence map›Paper›PMID 35193624›Full record

SynthesisJournal of neuroengineering and rehabilitation2022

Effects of transcranial magnetic stimulation in modulating cortical excitability in patients with stroke: a systematic review and meta-analysis.

Zhongfei Bai, Jiaqi Zhang, Kenneth N K Fong

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of neuroengineering and rehabilitation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07787793 (Effects of a Single Session of High-Frequency Repetitive Transcranial Magnetic Stimulation on Cortical Mapping of the Upper Limb in Stroke Patients With Severe Upper Limb Impairment), which is not on this map. Cited by 84 papers, 24 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 24 pooled it
10.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07787793 narecruitingnot on this mapstarted 2026, after this paper: background citation

Effects of a Single Session of High-Frequency Repetitive Transcranial Magnetic Stimulation on Cortical Mapping of the Upper Limb in Stroke Patients With Severe Upper Limb Impairment

TypeinterventionalSponsorAncor Rebassa CabreraRan2026 to 2026Enrolled54ConditionsStroke, Upper Limb ParesisArmsHigh-frequency repetitive transcranial magnetic stimulation, Sham transcranial magnetic stimulation
3 · Its place in the literature

Who cites it

84 citing papers in PubMed, 24 syntheses or guidelines pooled it, 138 citations in OpenAlex.

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  7. Systematic review of repetitive transcranial magnetic stimulation for post-stroke hemiplegic shoulder pain.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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  14. The effects of rTMS on motor recovery after stroke: a systematic review of fMRI studies.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
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  20. High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) impacts activities of daily living of patients with post-stroke cognitive impairment: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023
    Pooled it

24 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 2 countries.

Zhongfei BaiDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
Jiaqi ZhangDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
Kenneth N K FongDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China. rsnkfong@polyu.edu.hk.ORCID 0000-0001-5909-4847
Hong Kong Polytechnic University · HKTongji University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTranscranial magnetic stimulation (TMS) has attracted plenty of attention as it has been proved to be effective in facilitating motor recovery in patients with stroke. The aim of this study was to systematically review the effects of repetitive TMS (rTMS) and theta burst stimulation (TBS) protocols in modulating cortical excitability after stroke.

methodsA literature search was carried out using PubMed, Medline, EMBASE, CINAHL, and PEDro, to identify studies that investigated the effects of four rTMS protocols-low and high frequency rTMS, intermittent and continuous TBS, on TMS measures of cortical excitability in stroke. A random-effects model was used for all meta-analyses.

resultsSixty-one studies were included in the current review. Low frequency rTMS was effective in decreasing individuals' resting motor threshold and increasing the motor-evoked potential of the non-stimulated M1 (affected M1), while opposite effects occurred in the stimulated M1 (unaffected M1). High frequency rTMS enhanced the cortical excitability of the affected M1 alone. Intermittent TBS also showed superior effects in rebalancing bilateral excitability through increasing and decreasing excitability within the affected and unaffected M1, respectively. Due to the limited number of studies found, the effects of continuous TBS remained inconclusive. Motor impairment was significantly correlated with various forms of TMS measures.

conclusionsExcept for continuous TBS, it is evident that these protocols are effective in modulating cortical excitability in stroke. Current evidence does support the effects of inhibitory stimulation in enhancing the cortical excitability of the affected M1.

Indexed as

Cortical ExcitabilityMotor CortexStrokeEvoked Potentials, MotorHumansTranscranial Magnetic StimulationCortical excitabilityInterhemispheric imbalanceMotor-evoked potentialsStrokeTranscranial magnetic stimulation

Identifiers

PMID35193624
PMCPMC8862292
OpenAlexW4212974759

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.