Abstract Details

Title Cerebellar Neuromodulation via Non-invasive Brain Stimulation vs. Conventional therapy: A Meta-analysis and Systematic Review of Spinocerebellar Ataxia Patients

Topic Neuro-rehabilitation

Presentation(s) S17 - Neuro-rehabilitation: Expanding Therapeutic Approaches (3:54 PM-4:06 PM)

Poster/Presentation
Number 003

Objective Our study analyzes the efficacy of non-invasive techniques—repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and transcranial alternating current stimulation—in improving motor and functional outcomes in patients with Spino Cerebellar Ataxia (SCA).

Background Spinocerebellar ataxia (SCA) is a hereditary neurodegenerative disorder marked by progressive cerebellar dysfunction, impaired motor coordination, and diverse neurological deficits. Despite better understanding of its mechanisms, effective therapeutic options remain limited, creating an urgent need for novel interventions.

Design/Methods

Following PRISMA guidelines (PROSPERO: 1502246451002180), we systematically searched PubMed, Google Scholar, Cochrane Library, ClinicalTrials.gov, Embase, Scopus, and ScienceDirect for RCTs evaluating non-invasive brain stimulation in spinocerebellar ataxia patients. Primary outcomes were motor function assessed by SARA and ICARS scales; secondary outcome was double-support time variability (DSSD). We included eight RCTs involving 309 participants. The analysis was conducted using RevMan (v5.4.1) to pool mean and standard deviation. Sensitivity analysis was done using R-studio (v2025.05.0+496) through metainf() function.

Results We included eight randomized controlled trials involving 309 patients (154 intervention, 155 control), mostly with SCA-3. Non-invasive brain stimulation (NIBS) significantly improved motor function compared to sham/control. SARA scores decreased at 2 weeks (3 studies, n=178; MD: -1.88, 95% CI: -3.09 to -0.66, p=0.002) and 6 weeks (2 studies, n=84; MD: -3.24, 95% CI: -5.76 to -0.71, p=0.01). Double-support time variability improved at 2 weeks (MD: -1.09, 95% CI: -2.07 to -0.11, p=0.03) and 6 weeks (MD: -1.51, 95% CI: -2.63 to -0.40, p=0.008). Other ICARS sub-scores (limb kinetics, oculomotor disorders, posture and speech disorders) showed no significant differences. Overall heterogeneity remained low-to-moderate, with no serious adverse events reported.

Conclusions

Non-invasive brain stimulation improves motor function and gait stability in SCA, especially SCA3, with no major safety issues. Larger trials and multidisciplinary approaches are needed to confirm long-term efficacy.

Authors/Disclosures
Taha Khalid, MD PRESENTER	Dr. Khalid has nothing to disclose.
Waqas Ahmad, MBBS	Mr. Ahmad has nothing to disclose.
Rana A. Mushtaq, MBBS	Mr. Mushtaq has nothing to disclose.
Hafsa Iqbal, MBBS	Miss Iqbal has nothing to disclose.
Arbaz Hassan, MBBS	Mr. Hassan has nothing to disclose.
Maryam Sial, MBBS	Miss Sial has nothing to disclose.
Mahnoor Fatima, MBBS	Dr. Fatima has nothing to disclose.
Jamil Numan, MD (Marshall University/ MUSOM)	Dr. Numan has nothing to disclose.
Atif N. Malik, MD	Dr. Malik has nothing to disclose.
Anfal Hamza	Mr. Hamza has nothing to disclose.
Syed H. Inam, MD	Dr. Inam has nothing to disclose.

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