Comparison of efficacy of deep brain stimulation, repeat transcranial magnetic stimulation, and behavioral therapy in Tourette syndrome: A systematic review and Bayesian Network Meta-Analysis

Xiaofeng Lin; Fabin Lin; Huiyun Chen; Yanhong Weng; Junping Wen; Qinyong Ye; Chunmei Chen; Guoen Cai

Heliyon (Oct 2022)

Comparison of efficacy of deep brain stimulation, repeat transcranial magnetic stimulation, and behavioral therapy in Tourette syndrome: A systematic review and Bayesian Network Meta-Analysis

Xiaofeng Lin,
Fabin Lin,
Huiyun Chen,
Yanhong Weng,
Junping Wen,
Qinyong Ye,
Chunmei Chen,
Guoen Cai

Affiliations

Xiaofeng Lin: Department of Neurology, Union Hospital, Institute of Neuroscience, Institute of Clinical Neurology, Fujian Medical University, Fuzhou 350001, China; Endocrinology, Fujian Provincial Hospital, Fuzhou 350001, China
Fabin Lin: Department of Neurology, Union Hospital, Institute of Neuroscience, Institute of Clinical Neurology, Fujian Medical University, Fuzhou 350001, China; Department of Clinical Medicine, Fujian Medical University, Fuzhou 350001, China; Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
Huiyun Chen: Fujian Province Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fujian 35008, China
Yanhong Weng: Department of Neurology, Union Hospital, Institute of Neuroscience, Institute of Clinical Neurology, Fujian Medical University, Fuzhou 350001, China
Junping Wen: Endocrinology, Fujian Provincial Hospital, Fuzhou 350001, China; Corresponding author.
Qinyong Ye: Department of Neurology, Union Hospital, Institute of Neuroscience, Institute of Clinical Neurology, Fujian Medical University, Fuzhou 350001, China
Chunmei Chen: Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou 350001, China; Corresponding author.
Guoen Cai: Department of Neurology, Union Hospital, Institute of Neuroscience, Institute of Clinical Neurology, Fujian Medical University, Fuzhou 350001, China; Department of Clinical Medicine, Fujian Medical University, Fuzhou 350001, China; Corresponding author.

Journal volume & issue: Vol. 8, no. 10
p. e10952

Abstract

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Background: Tourette syndrome (TS) is an incurable neuropsychiatric disorder. Deep brain stimulation (DBS), repeat transcranial magnetic stimulation (rTMS), and behavioral therapy (BT) are all effective treatments. However, the comparison of therapeutic effect of these three therapies is lacking. Methods: A systematic literature search was conducted for randomized controlled studies (RCT). A network meta-analysis by R4.04 software according to Bayesian framework were performed. Results were meta-analyzed and network meta-analyzed to evaluate and compare the efficacy of DBS, rTMS and BT in TS patients. Results: A total of 18 randomized controlled studies with 661 participants were included. The Yale Global Tic Severity Scale (YGTSS) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were utilized to evaluate the symptoms of TS. All three treatments improved the tic symptoms of TS [DBS 12.11 (95%CI 7.58–16.65); rTMS 4.96 (95%CI 1.01–10.93); andBT 11.72 (95%CI 10.42–13.01)]; and obsessive-compulsive symptom [DBS 4.9 (95%CI 1.13–8.67); rTMS 5.28 (95%CI 0.21–10.77); and BT 1.61 (95%CI 0.74–2.48)]. The cumulative probability results showed that DBS had the best effect on the improvement of tic symptoms, followed by BT; and rTMS was ranked last. However, in terms of improvement of obsessional symptoms, rTMS was ranked first, DBS was ranked second, and BT was ranked last. In addition, the meta regression analysis of YGTSS in DBS, rTMS and BT has significant difference (P = 0.05). Limitation: Due to the lack of quantitative indicators, we did not perform a network meta-analysis of the side effects of the three treatments. Conclusion: Our study showed that DBS, rTMS, and BT are effective in TS. DBS causes the best improvement in tic symptoms, and rTMS is the most effective in improving the obsessive-compulsive symptoms.

Published in Heliyon

ISSN: 2405-8440 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Science: Science (General); Social Sciences: Social sciences (General)
Website: https://www.cell.com/heliyon/home

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