Transcranial magnetic stimulation for lower limb spasticity in patients with brain injuries:a scoping review

Peng Qiuyi; Liu Lu; Yang Man; Liao Lingyi; Gao Changyue

doi:10.3969/j.issn.1009-4237.2025.02.005

Abstract：Objective To summarize the effect of transcranial magnetic stimulation(TMS)for treating lower limb spasticity in patients with brain injuries.Methods The databases of PubMed,Web of Science,Chinese biomedical literature,CNKI,and Wanfang were retrieved for literature focusing on TMS treatment of lower limb spas-ticity following brain injuries(published before Mar.12,2024),using the keywords of"muscle spasticity","brain injury","transcranial magnetic stimulation","脑损伤","经颅磁刺激","痉挛".Two researchers screened and collated the literature according to the scoping review reporting guidelines checklist.Duplicate records were re-moved.Primary screening was conducted by browsing the titles and abstracts.For uncertain studies,the full texts were read by a third researcher.The extracted information included the first author,publication year,country,type of injury,gender,age,disease duration,intervention measures,research design type,outcome indicators,main results,and TMS treatment parameters.Results A total of 16 studies were finally included,including 3 in English and 13 in Chinese.The studies came from three countries,respectively China(13 studies),Iran(2 studies),and Italy(1 study).Among the included studies,13 were randomized controlled trials,2 crossover studies,and 1 longitudinal study.Twelve studies set the contralateral primary motor cortex(M1)as the stimulation site,3 targeted the ipsilat-eral M1,and 1 targeted bilateral M1 regions.Except for one study that reported a negative outcome,the remaining 15 studies reported beneficial effects of TMS on lower limb spasticity in patients with brain injuries.Five studies con-ducted adverse effects observation,with 3 reporting no adverse effect throughout the study period.Conclusion TMS emerges as a non-invasive,safe neuromodulation technique.Stimulating the M1 using TMS is beneficial for lower limb spasticity in patients with brain injuries,with no reported severe adverse reaction and good safety.