Effectiveness of high-frequency repetitive transcranial magnetic stimulation coupled with rehabilitation in patients with spinal cord injury: a systematic review.

BACKGROUND

Spinal Cord Injury (SCI) leads to partial or complete sensorimotor loss because of the spinal lesions caused either by trauma or any pathological conditions. Rehabilitation, one of the therapeutic methods, is considered to be a significant part of therapy supporting patients with spinal cord injury. Newer methods are being incorporated, such as repetitive Transcranial Magnetic Stimulation (rTMS), a Non-Invasive Brain Stimulation (NIBS) technique to induce changes in the residual neuronal pathways, facilitating cortical excitability and neuroplasticity.

STUDY

DESIGN

PRISMA-guided systematic review.

OBJECTIVE

To comprehend the therapeutic efficacy of rTMS combined with rehabilitation in SCI patients by evaluating the results reported in previous studies.

METHODOLOGY: An online electronic search was executed on the scientific databases, PUBMED, COCHRANE LIBRARY, and SCOPUS using the keywords: 'Spinal Cord Injury (SCI),' 'repetitive Transcranial Magnetic Stimulation (rTMS),' and 'rehabilitation' and articles published in the English language between the years 2010 to 2024 were screened and extracted based on the eligibility criteria according to PICOS framework.

RESULTS

Four full-text articles were selected and analysed. Following HF-rTMS and neuro-rehabilitation, significant upper and lower extremity functional gains marked by UEMS & LEMS and a reduction in lower limb spasticity were reported by MAS scores in active SCI groups.

CONCLUSION

To modulate corticospinal tract fiber excitability and reduce spasticity in patients with SCI, HF-rTMS shows promising therapeutic effects if combined with a rehabilitation program.

PROSPERO ID: CRD420251028333.