Repetitive transcranial magnetic stimulation improves cardiovascular autonomic nervous system control: A meta-analysis
Author: Hanall Lee1, Joon Ho Lee2, Moon-Hyon Hwang3, Nyeonju Kang4
Affiliation:
1 Department of Human Movement Science, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea. Electronic address: hlee2500@inu.ac.kr.
2 Department of Human Movement Science, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea. Electronic address: ljhgo7@inu.ac.kr.
3 Department of Human Movement Science, Incheon National University, Incheon, South Korea; Division of Health & Kinesiology, Incheon National University, Incheon, South Korea. Electronic address: mhwang@inu.ac.kr.
4 Department of Human Movement Science, Incheon National University, Incheon, South Korea; Division of Sport Science, Sport Science Institute & Health Promotion Center, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea. Electronic address: nyunju@inu.ac.kr.
Conference/Journal: J Affect Disord
Date published: 2023 Jul 15
Other:
Special Notes: doi: 10.1016/j.jad.2023.07.039. , Word Count: 240
Background:
Cardiovascular autonomic system (ANS) may be affected by altered neural activations in the brain. This systematic review and meta-analysis investigated potential effects of repetitive transcranial magnetic stimulation (rTMS) protocols on cardiovascular ANS control.
Methods:
Through 19 qualified studies, we acquired 70 comparisons for data synthesis. Individual effect sizes were estimated by comparing changes in following cardiovascular ANS control variables between active and sham stimulation conditions: (a) blood pressure (BP), (b) heart rate (HR), and (c) heart rate variability (HRV). Moreover, two moderator variable analyses determined whether changes in cardiovascular ANS control were different based on (a) rTMS protocols (excitatory rTMS versus inhibitory rTMS) and (b) specific targeted cortical regions, respectively.
Results:
The random-effects model meta-analysis revealed significant improvements in cardiovascular ANS control after the rTMS protocols. Specifically, applying excitatory and inhibitory rTMS protocols significantly decreased values of BP and HR variables. For HRV variables, excitatory rTMS protocols showed significant positive effects. These improvements in cardiovascular ANS control were observed while applying either excitatory rTMS protocols to the left dorsolateral prefrontal cortex or inhibitory rTMS protocols to the right dorsolateral prefrontal cortex.
Limitations:
Relatively small number of studies for inhibitory rTMS on the right dorsolateral prefrontal cortex were included in this meta-analysis.
Conclusion:
These findings suggest that applying excitatory and inhibitory rTMS protocols on prefrontal cortical regions may be effective to improve cardiovascular ANS control.
Keywords: Autonomic nervous system; Cardiac responses; Dorsolateral prefrontal cortex; Repetitive transcranial magnetic stimulation.
PMID: 37459970 DOI: 10.1016/j.jad.2023.07.039
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