Abstract Details

Title Cerebellar Repetitive Transcranial Magnetic Stimulation for Essential Tremor: A Systematic Review and Meta-analysis

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-004

Objective

Aim to evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) in essential tremor (ET).

Background Essential tremor significantly impairs patient autonomy and often responds poorly to standard pharmacological or surgical treatments. rTMS may be an option after first-line therapy failure, though its efficacy remains uncertain, requiring further investigation into its therapeutic potential and safety.

Design/Methods We conducted a systematic review and meta-analysis following PRISMA guidelines, extracting data from PubMed, Embase, and Cochrane databases. We included studies that compared patients with ET treated with rTSM with patients treated with shaw therapy or other therapy available. The primary outcome was the Fahn-Tolosa-Marin (FTM) total score, with secondary outcomes being the FTM subscale A (tremor severity), subscale B (motor task), and subscale C (functional disability). All of the outcomes were analyzed after 1 month of follow-up. Proportions with 95% confidence intervals (CIs) were calculated using a random-effects model. Statistical analysis was performed in RStudio version 4.2.3.

Results

Three randomized clinical trials (RCTs) involving ET 89 patients with a mean age of 55.3 years were analyzed. rTMS significantly reduced the total FTM score (MD: -13.39; [-14.67, -12.12]; I² = 0%), demonstrating consistent efficacy. Tremor severity improved (MD: -3.03; [-5.56, -0.49]), though heterogeneity was high (I² = 87%). rTMS also enhanced motor task performance (MD: -4.70; [-6.58, -2.82]; I² = 15%) and reduced functional disability (MD: -2.99; [-3.37, -2.62]; I² = 0%), therefore, showing significant benefits across all measures.

Conclusions Our study demonstrates that rTMS significantly improves tremor severity, motor function, and daily activities in essential tremor patients. However, the safety profile of rTMS should be better determined in further studies. RCTs with larger patient populations are needed to optimize treatment protocols.

Authors/Disclosures
Emanuelly L. Barbosa PRESENTER	Ms. Barbosa has nothing to disclose.
David B. Abraham, MS	Mr. Abraham has nothing to disclose.
Frederico M. de Sousa Marinho Mendes Filho	Mr. de Sousa Marinho Mendes Filho has nothing to disclose.
Rebeca O. Silva, Student	Miss Silva has nothing to disclose.
Giovanna Salema Pascual	Miss Salema Pascual has nothing to disclose.
Christian K. Fukunaga, MS (Medical Student)	Mr. Fukunaga has nothing to disclose.
Elizabet Taylor P. Weba, Jr., Student	Miss Weba has nothing to disclose.
Luis O. Nogueira, medical student	Mr. NOGUEIRA has nothing to disclose.
Rafaela Farias Vidigal Nascimento, MD	Miss Nascimento has nothing to disclose.
Kenzo Ogasawara, MD	Dr. Ogasawara has nothing to disclose.
Leonardo Pipek, MD (University of São Paulo)	Dr. Pipek has nothing to disclose.
Pablo V. Feitoza, MD, PhD	Prof. Feitoza has nothing to disclose.

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