Table 1.
Study participant characteristics of the included trials.
| Included studies | Country | Design | Age(years) | Disease duration (years) |
Treatment duration |
H & Y | Interventions | Simple size |
|---|---|---|---|---|---|---|---|---|
| Benninger et al (2011) | Switzerland | Parallel | EG: 62.1 ± 6.9 CG: 65.6 ± 9.0 |
EG: 10.8 ± 7.1 CG: 6.5 ± 3.4 |
2 weeks | 2– 4 | EG: real-iTMS CG: sham-iTMS |
EG: 13 CG: 13 |
| Benninger et al (2012) | Switzerland | Parallel | EG: 64.5 ± 12.5 CG: 55.8 ± 9.1 |
EG: 8.6 ± 4.1 CG: 9.3 ± 6.8 |
2 weeks | 2–4 | EG: real-rTMS CG: sham-rTMS |
EG: 13 CG: 13 |
| Brusa et al (2006) | Italy | Crossover | 61 ± 8.04 | 16.4 ± 5.4 | 5 days | 1–3 | EG: real-rTMS CG: sham-rTMS |
EG: 10 CG: 10 |
| Chang et al (2016) | Korea | Crossover | 71.9 ± 7.8 | 4.3 ± 1.8 | 5 days | UK | EG: real-rTMS CG: sham-rTMS |
EG: 8 CG: 8 |
| Chung et al (2020) | China | Parallel | EG1: 62.1 ± 5.7 EG2: 62.7 ± 6.8 CG: 62.1 ± 5.7 |
EG1: 7.5 ± 4.9 EG2: 5.2 ± 3.4 CG: 6.9 ± 3.3 | 3 weeks | EG1: 2.2 ± 0.4 EG2: 2.2 ± 0.3 CG: 2.3 ± 0.3 | EG: real-rTMS CG: sham-rTMS |
EG1: 17 EG2: 17 CG: 16 |
| Cohen et al (2018) | Israel | Parallel | EG: 64.4 ± 6.8 CG: 66.8 ± 8.1 |
EG: 4.7 ± 3.4 CG: 5.6 ± 3.7 |
3 months | 2.0 ± 0.37 | EG: real-rTMS CG: sham-rTMS |
EG: 21 CG: 21 |
| Del Olmo et al (2007) | Spain | Parallel | 61.7 ± 5.22 | 8.0 ± 5.0 | 10 days | 2–3 | EG: real-rTMS CG: sham-rTMS |
EG: 8 CG: 5 |
| Eggers et al (2015) | Germany | Crossover | 65 ± 5 | 5.8 ± 5.0 | 1 day | 1.8 ± 0.8 | EG: real-rTMS CG: sham-rTMS |
EG: 13 CG: 13 |
| Filipović et al (2010) | England | Crossover | 64.5 ± 9.6 | 15.6 ± 5.7 | 4 days | 3.3 ± 0.7 | EG: real-rTMS CG: sham-rTMS |
EG: 10 CG: 10 |
| Flamez et al (2016) | Belgium | Crossover | 68.8 ± 10.3 | 14 ± 5 | 5 days | 3 ± 1 | EG: real-rTMS CG: sham-rTMS |
EG: 6 CG: 6 |
| Grobe-Einsler et al (2024) | Germany | Parallel | EG: 66.06 ± 9.70 CG: 70.41 ± 10.37 |
UK | 5 days | 2 | EG: real-rTMS CG: sham-rTMS |
EG: 17 CG: 13 |
| Hamada et al et al (2009) | Japan | Parallel | EG: 65.3 ± 8.9 CG: 67.4 ± 8.5 |
EG: 8.1 ± 4.2 CG: 7.8 ± 6.7 |
8 weeks | 2–4 | EG: real-rTMS CG: sham-rTMS |
EG: 55 CG: 43 |
| Ji et al (2020) | China | Parallel | EG: 61.7 ± 1.57 CG: 60.2 ± 1.97 |
EG: 4.3 ± 0.52 CG: 5.3 ± 0.83 |
14 days | EG: 1.6 ± 0.12 CG: 1.7 ± 0.11 | EG: real-rTMS CG: sham-rTMS |
EG: 22 CG: 20 |
| Khedr et al (2003) | Egypt | Parallel | EG: 57.8 ± 9.2 CG: 57.5 ± 8.4 |
EG: 3.45 ± 2.3 CG: 3.05 ± 2.1 |
10 days | 2–3 | EG: real-rTMS CG: sham-rTMS |
EG: 19 CG: 17 |
| Khedr et al (2006) | Egypt | Parallel | EG: 60.2 ± 9.48 CG: 60.6 ± 10.6 |
EG: 3.5 ± 0.7 CG: 3.8 ± 0.9 |
6 days | 3–5 | EG: real-rTMS CG: sham-rTMS |
EG: 10 CG: 10 |
| Khedr et al (2019) | Egypt | Parallel | EG: 60.7 ± 8.8 CG: 57.4 ± 10 | EG: 5.7 ± 3.9 CG: 6.5 ± 3.7 | 10 days | EG: 3.1 ± 1.1 CG: 3.5 ± 1.0 | EG: real-rTMS CG: sham-rTMS |
EG: 19 CG: 11 |
| Khedr et al (2024) | Egypt | Parallel | EG: 61.82 ± 3.48 CG: 60.21 ± 1.64 | EG: 7.12 ± 3.48 CG: 5.87 ± 4.08 | 10 days | UK | EG: real-rTMS CG: sham-rTMS |
EG: 16 CG: 8 |
| Kim et al (2015) | Korea | Crossover | 64.5 ± 8.4 | 7.8 ± 4.9 | 5 days | 3.0 ± 0.5 | EG: real-rTMS CG: sham-rTMS |
EG: 17 CG: 17 |
| Koch et al (2005) | Italy | Crossover | EG: 60.75 ± 9.84 | EG: 16.5 ± 5.93 | 1 day | UK | EG: real-rTMS CG: sham-rTMS |
EG: 8 CG: 8 |
| Lee et al (2014) | Korea | Crossover | 71.6 ± 8.6 | 4.7 ± 2.6 | 1 day | 3.4 ± 0.5 | EG: real-rTMS CG: sham-rTMS |
EG: 20 CG: 20 |
| Li et al (2020) | China | Parallel | EG: 61.7 ± 6.9 CG: 61.5 ± 8.4 | EG: 5.5 ± 3.7 CG: 6.5 ± 5.1 | 5 days | EG: 1.9 ± 0.6 CG: 1.8 ± 0.6 | EG: real-rTMS CG: sham-rTMS |
EG: 24 CG: 24 |
| Lomarev et al (2006) | USA | Parallel | EG: 63 ± 10 CG: 66 ± 10 | EG: 13.8 ± 6.8 CG: 10.8 ± 3.1 | 8 days | 2–4 | EG: real-rTMS CG: sham-rTMS |
EG: 9 CG: 9 |
| Maruo et al (2013) | Japan | Crossover | 63.0 ± 11.3 | 12.0 ± 6.3 | 3 days | 3.1 ± 0.5 | EG: real-rTMS CG: sham-rTMS |
EG: 21 CG: 21 |
| Mi et al (2020) | China | Parallel | EG: 62.7 ± 10.6 CG: 65.6 ± 8.7 | EG: 9.2 ± 5.8 CG: 7.4 ± 4.8 | 10 days | EG: 2.6 ± 0.9 CG: 2.4 ± 0.9 | EG: real-rTMS CG: sham-rTMS |
EG: 20 CG: 10 |
| Brys et al (2016) | Canada | Parallel | EG1: 64.9 ± 8.0 EG2: 59.6 ± 12.6 EG3: 64.6 ± 12.3 CG: 64.0 ± 7.4 | EG1: 7.3 ± 5.6 EG2: 8.4 ± 5.2 EG3: 7.7 ± 4.2 CG: 4.5 ± 2.2 | 10 days | EG1: 2.5 EG2: 2.92 EG3: 2.65 CG: 2.53 | EG: real-rTMS CG: sham-rTMS |
EG1: 20 EG2:14 EG3: 12 CG: 15 |
| Romero et al (2024) | Spain | Parallel | EG: 64.4 ± 6.38 CG: 66.89 ± 9.07 | EG: 6.0 ± 3.06 CG: 6.22 ± 4.12 | 10 days | 1–3 | EG: real-rTMS CG: sham-rTMS |
EG: 10 CG: 9 |
| Pal et al (2010) | Hungary | Parallel | EG: 68.5 CG: 67.5 | EG: 6.0 ± 1.6 CG: 6.5 ± 1.7 | 10 days | UK | EG: real-rTMS CG: sham-rTMS |
EG: 12 CG: 10 |
| Shimamoto et al (2001) | Japan | Parallel | EG: 65.1 ± 8.0 CG: 64.5 ± 6.6 | EG: 7.0 ± 4.2 CG: 7.3 ± 6.5 | 2 months | 1–4 | EG: real-rTMS CG: sham-rTMS |
EG: 9 CG: 9 |
| Shin et al (2016) | Korea | Parallel | EG: 69 ± 6.75 CG: 67 ± 6.25 | UK | 2 weeks | 1–3 | EG: real-rTMS CG: sham-rTMS |
EG: 10 CG: 8 |
| Shirota et al (2013) | Japan | Parallel | EG1: 68.8 ± 7.6 EG2: 67.9 ± 8.4 CG: 65.7 ± 8.5 | EG1: 8.5 ± 7.3 EG2: 7.8 ± 6.6 CG: 7.6 ± 4.4 | 8 days | 2–3 | EG: real-rTMS CG: sham-rTMS |
EG1: 34 EG2:34 CG: 34 |
| Song et al (2024) | China | Parallel | EG: 67.36 ± 6.99 CG: 70.50 ± 6.76 | EG: 6.18 ± 1.67 CG: 6.77 ± 2.02 | 10 days | 2–4 | EG: real-rTMS CG: sham-rTMS |
EG: 22 CG: 22 |
| Spagnolo et al (2021) | Italy | Parallel | EG1: 60.4 ± 8.1 EG2: 63.9 ± 10 CG: 64.2 ± 5.5 | EG1: 5.8 ± 2.1 EG2: 7.6 ± 4.9 CG: 7.2 ± 3.0 | 12 days | 2 | EG: real-rTMS CG: sham-rTMS |
EG1: 20 EG2: 19 CG: 20 |
| Sun et al (2024) | China | Parallel | EG: 61.91 ± 1.73 CG: 59.41 ± 8.91 | EG: 4.25 ± 0.61 CG: 5.47 ± 3.97 | 14 days | EG: 1.55 ± 0.11 CG: 1.68 ± 0.50 | EG: real-rTMS CG: sham-rTMS |
EG: 22 CG: 17 |
| Wen et al (2022) | China | Parallel | EG: 67.54 ± 1.95 CG: 67.18 ± 2.86 | EG: 5.02 ± 0.99 CG: 4.13 ± 0.75 | 10 days | EG: 2.42 ± 0.14 CG: 2.46 ± 0.23 | EG: real-rTMS CG: sham-rTMS |
EG: 13 CG: 11 |
| Yang et al (2012) | China | Parallel | EG: 65.20 ± 11.08 CG: 67.00 ± 13.21 | EG: 6.40 ± 2.76 CG: 6.35 ± 3.58 | 12 days | EG: 2.3 ± 0.4 CG: 2.4 ± 0.4 | EG: real-rTMS CG: sham-rTMS |
EG: 10 CG: 10 |
| Yokoe et al (2017) | Japan | Crossover | 69.1 ± 8.4 | 9.5 ± 3.2 | 3 days | 3.5 ± 0.6 | EG: real-rTMS CG: sham-rTMS |
EG1: 19 EG2: 19 EG3: 19 CG: 19 |
| Zhuang et al (2020) | China | Parallel | EG: 60.58 ± 9.21 CG: 61.57 ± 13.25 | EG: 5.86 ± 4.36 CG: 5.71 ± 3.77 | 10 days | EG: 2 ± 0.74 CG: 2.25 ± 0.93 | EG: real-rTMS CG: sham-rTMS |
EG: 19 CG: 14 |
| Makkos et al (2016) | Hungary | Parallel | EG: 67 ± 9.63 CG: 66 ± 5.93 | EG: 6 ± 5.19 CG: 5 ± 4.44 | 10 days | 1–4 | EG: real-rTMS CG: sham-rTMS |
EG: 23 CG: 21 |
| Ma et al (2019) | China | Parallel | EG: 59.94 ± 9.16 CG: 66.00 ± 8.55 | EG: 8.94 ± 5.48 CG: 7.50 ± 4.72 | 10 days | EG: 2.42 CG: 2.4 | EG: real-rTMS CG: sham-rTMS |
EG: 18 CG: 10 |
| Arias et al (2010) | Spain | Parallel | UK | UK | 10 days | 2–4 | EG: real-rTMS CG: sham-rTMS |
EG: 9 CG: 9 |
| Lench et al (2021) | USA | Parallel | EG: 66.6 ± 7.5 CG: 64.5 ± 8.9 | EG: 8.7 ± 7.1 CG: 8.0 ± 5.6 | 10 days | EG: 2.3 ± 0.4 CG: 2.3 ± 0.3 | EG: real-rTMS CG: sham-rTMS |
EG: 12 CG: 8 |
| W.He et al (2021) | China | Parallel | EG: 70.0 ± 6.3 CG: 74.8 ± 6.9 | EG: 2.7 ± 1.5 CG: 2.5 ± 1.1 | 10 days | EG: 2.1 ± 1.1 CG: 2.5 ± 1.0 | EG: real-rTMS CG: sham-rTMS |
EG: 20 CG: 15 |
| Cheng et al (2022) | China | Parallel | EG: 71.6 ± 5.1 CG: 73.9 ± 6.9 | UK | 14 days | EG: 3.0 ± 1.2 CG: 2.5 ± 1.0 | EG: real-rTMS CG: sham-rTMS |
EG: 11 CG: 16 |
| Lefaucheur et al (2004) | France | Crossover | 64 ± 2 | 11 ± 1 | 1 day | 3.4 ± 0.2 | EG: real-rTMS CG: sham-rTMS |
EG: 12 CG: 12 |
| Siebner et al (2000) | Germany | Crossover | 57 ± 11 | 5.5 ± 3.4 | 1 day | 1–2 | EG: real-rTMS CG: sham-rTMS |
EG: 10 CG: 10 |
EG, experimental Croup; CG, control Croup; USA, the United States of America; rTMS, repetitive transcranial magnetic stimulation; iTBS, intermittent theta burst stimulation; UK, unknown.