SynthesisCerebellum (London, England)2025
Evaluating Repetitive Transcranial Magnetic Stimulation in Spinocerebellar Ataxia: A Meta-Analysis of Efficacy and Safety.
Synthesis in Cerebellum (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Authors and funding
4 authors.
Funding
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Abstract
To evaluate the efficacy and safety of repetitive Transcranial Magnetic Stimulation (rTMS) in Spinocerebellar Ataxia (SCA) patients. We conducted a systematic review and meta-analysis of nine Randomized Controlled Trials (RCTs). Searches covered major databases (Medline, Embase, CENTRAL, etc.) and trial registries (ICTRP, ClinicalTrials.gov). We included RCTs comparing rTMS with sham stimulation on outcomes for efficacy (ataxia severity, quality of life) and safety (adverse events, tolerability). Data were extracted, bias was assessed (RoB 2), and certainty of evidence was evaluated using the GRADE approach. All included studies used sham stimulation, with follow-ups up to four weeks. Pooled analyses showed significant differences favoring rTMS immediately post-intervention for global ataxia severity (International Cooperative Ataxia Rating Scale-ICARS-: MD -4.07, low certainty; Scale for the Assessment and Rating of Ataxia-SARA-: MD-1.55, very low certainty). Moderate-certainty evidence demonstrated significant improvements in the ICARS subdomains for posture and gait (MD -1.53, p<0.00001) and limb function (MD -3.59, p<0.00001). However, no significant effect was found for speech disorders. rTMS was well-tolerated; safety assessment showed no significant difference in adverse events or dropout rates (low certainty), and no serious adverse events were reported. Evidence was insufficient to assess the quality of life or long-term effects. Low to very-low certainty evidence suggests that rTMS, compared to sham, provides slight but clinically relevant short-term improvement in motor function and global ataxia severity in SCA patients, with comparable safety profiles. Our effect estimations are derived from small, highly heterogeneous RCTs conducted predominantly in Asian cohorts with SCA3. Rigorous studies with longer follow-up are needed to confirm the sustained utility of this intervention.
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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.