Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018),Clinical Neurophysiology

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Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018)
Clinical Neurophysiology ( IF 4.7 ) Pub Date : 2020-02-01 , DOI: 10.1016/j.clinph.2019.11.002
Jean-Pascal Lefaucheur ₁ , André Aleman ₂ , Chris Baeken ₃ , David H Benninger ₄ , Jérôme Brunelin ₅ , Vincenzo Di Lazzaro ₆ , Saša R Filipović ₇ , Christian Grefkes ₈ , Alkomiet Hasan ₉ , Friedhelm C Hummel ₁₀ , Satu K Jääskeläinen ₁₁ , Berthold Langguth ₁₂ , Letizia Leocani ₁₃ , Alain Londero ₁₄ , Raffaele Nardone ₁₅ , Jean-Paul Nguyen ₁₆ , Thomas Nyffeler ₁₇ , Albino J Oliveira-Maia ₁₈ , Antonio Oliviero ₁₉ , Frank Padberg ₉ , Ulrich Palm ₂₀ , Walter Paulus ₂₁ , Emmanuel Poulet ₂₂ , Angelo Quartarone ₂₃ , Fady Rachid ₂₄ , Irena Rektorová ₂₅ , Simone Rossi ₂₆ , Hanna Sahlsten ₂₇ , Martin Schecklmann ₁₂ , David Szekely ₂₈ , Ulf Ziemann ₂₉

Affiliation

ENT Team, EA4391, Faculty of Medicine, Paris Est Créteil University, Créteil, France; Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France.
Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Department of Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
PsyR2 Team, U1028, INSERM and UMR5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), Centre Hospitalier Le Vinatier, Lyon-1 University, Bron, France.
Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
Department of Human Neuroscience, Institute for Medical Research, University of Belgrade, Belgrade, Serbia.
Department of Neurology, Cologne University Hospital, Cologne, Germany; Institute of Neurosciences and Medicine (INM3), Jülich Research Centre, Jülich, Germany.
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Defitech Chair in Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland; Defitech Chair in Clinical Neuroengineering, Swiss Federal Institute of Technology (EPFL) Valais and Clinique Romande de Réadaptation, Sion, Switzerland; Clinical Neuroscience, University of Geneva Medical School, Geneva, Switzerland.
Department of Clinical Neurophysiology, Turku University Hospital and University of Turku, Turku, Finland.
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
Department of Neurorehabilitation and Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), IRCCS San Raffaele, University Vita-Salute San Raffaele, Milan, Italy.
Department of Otorhinolaryngology - Head and Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Hôpital Européen Georges Pompidou, Paris, France.
Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria.
Multidisciplinary Pain Center, Clinique Bretéché, ELSAN, Nantes, France; Multidisciplinary Pain, Palliative and Supportive Care Center, UIC22-CAT2-EA3826, University Hospital, CHU Nord-Laënnec, Nantes, France.
Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Perception and Eye Movement Laboratory, Department of Neurology, University of Bern, Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland.
Champalimaud Research & Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain.
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Medical Park Chiemseeblick, Bernau, Germany.
Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.
PsyR2 Team, U1028, INSERM and UMR5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), Centre Hospitalier Le Vinatier, Lyon-1 University, Bron, France; Department of Emergency Psychiatry, Edouard Herriot Hospital, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France.
Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
Private Practice, Geneva, Switzerland.
Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic; First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Department of Medicine, Surgery and Neuroscience, Si-BIN Lab Human Physiology Section, Neurology and Clinical Neurophysiology Unit, University of Siena, Siena, Italy.
ENT Clinic, Mehiläinen and University of Turku, Turku, Finland.
Department of Psychiatry, Princess Grace Hospital, Monaco.
Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany.

A group of European experts reappraised the guidelines on the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) previously published in 2014 [Lefaucheur et al., Clin Neurophysiol 2014;125:2150-206]. These updated recommendations take into account all rTMS publications, including data prior to 2014, as well as currently reviewed literature until the end of 2018. Level A evidence (definite efficacy) was reached for: high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the painful side for neuropathic pain; HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC) using a figure-of-8 or a H1-coil for depression; low-frequency (LF) rTMS of contralesional M1 for hand motor recovery in the post-acute stage of stroke. Level B evidence (probable efficacy) was reached for: HF-rTMS of the left M1 or DLPFC for improving quality of life or pain, respectively, in fibromyalgia; HF-rTMS of bilateral M1 regions or the left DLPFC for improving motor impairment or depression, respectively, in Parkinson's disease; HF-rTMS of ipsilesional M1 for promoting motor recovery at the post-acute stage of stroke; intermittent theta burst stimulation targeted to the leg motor cortex for lower limb spasticity in multiple sclerosis; HF-rTMS of the right DLPFC in posttraumatic stress disorder; LF-rTMS of the right inferior frontal gyrus in chronic post-stroke non-fluent aphasia; LF-rTMS of the right DLPFC in depression; and bihemispheric stimulation of the DLPFC combining right-sided LF-rTMS (or continuous theta burst stimulation) and left-sided HF-rTMS (or intermittent theta burst stimulation) in depression. Level A/B evidence is not reached concerning efficacy of rTMS in any other condition. The current recommendations are based on the differences reached in therapeutic efficacy of real vs. sham rTMS protocols, replicated in a sufficient number of independent studies. This does not mean that the benefit produced by rTMS inevitably reaches a level of clinical relevance.

中文翻译：

重复经颅磁刺激 (rTMS) 治疗使用循证指南：更新（2014-2018）

一组欧洲专家重新评估了先前于 2014 年发布的关于重复经颅磁刺激 (rTMS) 治疗效果的指南 [Lefaucheur et al., Clin Neurophysiol 2014;125:2150-206]。这些更新的建议考虑了所有 rTMS 出版物，包括 2014 年之前的数据，以及截至 2018 年底的当前审查文献。达到了 A 级证据（确定疗效）：初级运动的高频 (HF) rTMS皮质（M1）对侧的神经性疼痛的疼痛侧；使用 8 字形或 H1 线圈治疗抑郁症的左背外侧前额叶皮层 (DLPFC) 的 HF-rTMS；用于中风急性期后手部运动恢复的对侧 M1 的低频 (LF) rTMS。达到 B 级证据（可能的疗效）：左 M1 或 DLPFC 的 HF-rTMS 分别用于改善纤维肌痛患者的生活质量或疼痛；双侧 M1 区域或左侧 DLPFC 的 HF-rTMS 分别用于改善帕金森病中的运动障碍或抑郁症；同侧 M1 的 HF-rTMS 促进中风急性期后运动恢复；针对多发性硬化症下肢痉挛的腿部运动皮层的间歇性 theta 脉冲刺激；创伤后应激障碍中右侧 DLPFC 的 HF-rTMS；慢性卒中后非流畅性失语症患者右侧额下回的LF-rTMS；抑郁症右侧 DLPFC 的 LF-rTMS；和 DLPFC 的双半球刺激结合右侧 LF-rTMS（或连续 theta 脉冲刺激）和左侧 HF-rTMS（或间歇性 theta 脉冲刺激）在抑郁症中。未达到关于 rTMS 在任何其他条件下的功效的 A/B 级证据。当前的建议基于真实与假 rTMS 协议在治疗功效上的差异，并在足够数量的独立研究中重复。这并不意味着 rTMS 产生的益处不可避免地达到了临床相关性的水平。

更新日期：2020-02-01

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