Table 3.
Treatment parameters of rTMS interventions on fatigue symptoms (n = 4).
| Author and year | Brain target | Type of coil | Intensity (RMT) | Frequency (HZ) | Total pulses per session | Number of sessions | Experiment group | Control group | Assessment of time points | Outcome measures | Findings |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mori et al. 34 | Leg area of M1 | / | 80% of AMT | 5/50 | / | 10 | Active iTBS + exercise | Sham iTBS + exercise | Before, after | MAS, MSSS-88, FSS |
iTBS significantly reduces spasticity and fatigue compared to sham stimulation |
| Korzhova et al. 36 | Both M1 | Figure of eight | 80% | E1: 20 E2: 5-35 |
E1: 1600 E2: 1200 |
10 | E1: active HF-rTMS + physical therapy E2: active iTBS |
E1: sham HF-rTMS + physical therapy E2: sham iTBS |
Before, after, 2w after, 12w after | MAS, NAS, SESS; MFIS; |
Both HF-rTMS and iTBS reduce spasticity, but only iTBS has long-term effects on spasticity compared to sham stimulation HF-rTMS also relieves pain and fatigue. compared to sham stimulation |
| Gaede et al. 27 | E1: LPFC E2: M1 |
E1: H6 E2: H10 |
E1: 120% of RMT E2: 90% of RMT |
E1: 18 E2: 5 |
E1: 1800 E2: 800 |
18 | Active rTMS | sham rTMS | Week1-6, 8, 10, 12 | FSS | rTMS of M1 significantly reduces fatigue compared to sham stimulation |
| Tramontano et al. 46 | Active: left cerebellum Sham: right cerebellum | Figure of eight | / | / | / | 10 | Active iTBS + vestibular rehabilitation | Sham iTBS + vestibular rehabilitation | Before, after | FSS | C-iTBS shows significant improvement of lower limb function compared to sham stimulation |
2MWT, Two-minute walking test; 5STS, Five repetition sit to stand test; AP, average power; A-tDCS, anodal tDCS; AMT, active motor threshold; BBS, Berg Balance Scale; BI, the Barthel Index; BPI, brief Pain Inventory; C-iTBS, cerebellar-iTBS; C3/C4, motor cortex; FDI, First dorsal interosseous; FSS, Fatigue Severity Scale; iTBS, intermittent transcranial magnetic theta burst stimulation; LPFC, lateral prefrontal cortex; MAS, modified Ashworth scale; MFIS, Modified Fatigue Impact Scale; MSSS-88, the 88 items Multiple Sclerosis Spasticity Score questionnaire; MSWS-12, Multiple sclerosis walking scale-12; NAS, numerical analog scale; NPS, Neuropathic Pain Scale; PLAS, pain level associated with spasticity; PT, peak torque; PT/BW, peak torque/ body weight; RDSS, the Rekand disability and spasticity score; RMT, rest motor threshold; S1, whole body somatosensory areas; SDMT, Symbol digit modalities test; SESS, the Subjective Evaluating Spasticity Scale; SPART, Spatial recall test; SRT, Select reminding test; T25-FW, Timed 25-foot walk; TBG, Tinetti Balance and Gait Scale; TPT, time to peak torque; TW, total work; WCST, Wisconsin card test; .