Evidence mapPaperPMID 40720525Full record

SynthesisPloS one2025

Enhancing functional motor outcomes in chronic stroke: A systematic review of the growing role of non-invasive brain stimulation.

Mirjam Bonanno, Maria Grazia Maggio, Angelo Quartarone, Giovanni Morone, Alessandro Marco De Nunzio, David Militi, Carmela Casella, Svonko Galasso, Rocco Salvatore Calabrò

Abstract readSystematic Review
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mirjam BonannoIRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy.
Maria Grazia MaggioIRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy.ORCID https://orcid.org/0000-0003-0757-2389
Angelo QuartaroneIRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy.
Giovanni MoroneDepartment of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.ORCID https://orcid.org/0000-0003-3602-4197
Alessandro Marco De NunzioDepartment of Research and Development, LUNEX International University of Health, Differdange, Luxembourg.
David MilitiOdontostomatology and Dental Surgery study, Messina, Italy.
Carmela CasellaAOU Policlinico G. Martino, Messina, Italy.
Svonko GalassoDepartment of Research and Development, LUNEX International University of Health, Differdange, Luxembourg.
Rocco Salvatore CalabròIRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNon-invasive brain stimulation (NIBS) promotes functional recovery by enhancing neuroplasticity and reorganizing brain networks. It is hypothesized that transcranial magnetic stimulation (TMS), repetitive transcranial magnetic stimulation (rTMS), or intermittent θ-burst stimulation (i-TBS) as well as trans direct current stimulation (tDCS) can modulate synaptic connectivity, through magnetic or electric stimuli, directly on the brain area. This systematic review aims to address the lack of comprehensive syntheses focusing on the comparative effectiveness of NIBS techniques, including tDCS, rTMS, and iTBS, on distinct motor domains (upper limb, lower limb, and vocal/swallowing functions) in chronic stroke patients. EVIDENCE ACQUISITION: A systematic search was conducted for all peer-reviewed articles published from January 2010 through September 2023, using the following databases: PubMed, Embase, Cochrane Database of Systematic Reviews, PEDro, RehabData, and Web of Science. This systematic review was performed following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with a registration number in the Prospective Register of Systematic Reviews (PROSPERO 2023) CRD42023458370. A total of 58 studies were included in the qualitative synthesis: 27 focused on upper limb rehabilitation, 13 on lower limb function, 13 on the combination of NIBS and robotic therapy, and 6 on vocal or swallowing functions. Most studies (78%) were randomized controlled trials. Among the NIBS techniques, tDCS showed stronger evidence for gait and balance recovery, while rTMS appeared more effective for upper limb function. Overall, the majority of studies presented a low risk of bias, although methodological issues such as inadequate randomization or blinding affected the reliability of some findings.

conclusionWe have systematically reviewed the literature on the use of NIBS to enhance motor outcomes (upper limb, lower limb, and vocal/swallowing functions) in individuals with chronic stroke. Findings indicate that rTMS demonstrates greater efficacy in improving upper limb motor function, whereas tDCS appears to be more effective in enhancing gait and balance recover.

Indexed as

BrainStrokeStroke RehabilitationTranscranial Direct Current StimulationTranscranial Magnetic StimulationChronic DiseaseHumansNeuronal PlasticityRecovery of FunctionTreatment OutcomeUpper Extremity

Identifiers

PMID40720525
PMCPMC12303356

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.