Role of non-invasive brain stimulation with repetitive transcranial magnetic stimulation in improving fine motor performance of post-stroke patients: a systematic review and meta-analysis

Non-invasive brain stimulation (NIBS) is one of the considered interventions to improve fine motor skills in stroke patients. However, there could be various frequencies and durations performed in each trial involving Non-Invasive Brain Stimulation that might affect the patient’s outcome. This research was to investigate the potential enhancement of fine motor performance in stroke patients through the application of non-invasive brain stimulation (NIBS) techniques. The literature search was carried out through 3 electronic databases, namely PubMed, Cochrane, and ScienceDirect which include articles published up to 31 December 2024, and published in English. Before selecting the studies, the study duplication was detected by Zotero Reference Manager® and then removed. The related studies examined and selected with rayyan.ai® website using a “blind-on” mode to ensure eligibility. Twenty-two studies comparing Non-Invasive Brain Stimulation vs. controls with the frequencies of outcomes used were Fugl-Meyer Assessment (68.4%), and Action Research Arm Test (15.7%) were reviewed with thirteen of them included in meta-analysis. All articles were randomized controlled trials. The effect size in repeated transcranial magnetic stimulation (rTMS) stroke comparisons was 2.58 (95% CI, 0.18–4.97; P = 0.04; Tau2, 19.05; I2, 99%; Q, 1367.54; P < 0.00001), whereas the Electrical Stimulation for theta burst stimulation (TBS) comparisons was 1.25 (95% CI, 0.01–2.49; P = 0.05; Tau2, 0.57; I2, 54%; Q, 4.34; P = 0.11). Conclusion: Non-invasive brain stimulation (NIBS) with rTMS is one of the considered interventions to improve fine motor skills in stroke patients. Non-Invasive Brain Stimulation has a better significance than the conventional therapy methods.