{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:49:39Z","timestamp":1785862179546,"version":"3.56.0"},"reference-count":70,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["projects 202340118"],"award-info":[{"award-number":["projects 202340118"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["2024ZZ1027"],"award-info":[{"award-number":["2024ZZ1027"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC3604504"],"award-info":[{"award-number":["2023YFC3604504"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As the core of motor control and learning, the cerebellum is crucial for maintaining posture, regulating muscle tone, and coordinating movement. In recent years, there has been an increase in the number of studies on the application of cerebellar transcranial magnetic stimulation (cTMS) to motor dysfunction in patients with stroke. This review aims to analyze cTMS efficacy for stroke patients and further explore the specific effects of different stages of the disease, stimulation modes, stimulation intensity, and treatment duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six databases were searched comprehensively\u2014CNKI, Wanfang, Web of Science, PubMed, The Cochrane Library, and Embase\u2014to collect randomized controlled trials (RCTs) up to October 2024 that investigated the improvement of physical motor dysfunction in stroke patients using cTMS. Two researchers screened the literature, extracted data, and independently assessed the quality and risk of bias of the included studies using the PEDro scale and the Cochrane Risk of Bias Assessment Tool 2. Meta\u2010analysis was performed using RevMan 5.4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 20 RCTs with 812 participants were included. Meta\u2010analysis and sensitivity analysis revealed that cTMS significantly improved BBS (Random, MD = 5.19, 95%CI = 3.66\u20136.72,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.00001), enhanced FMA\u2010LE scores (Random, MD = 1.88, 95%CI = 0.76\u20133.01,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001), shortened the TUG (Fix, MD = \u22121.64, 95%CI = \u22122.60 to \u22120.68,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0008), and 10MWT durations (Fix, MD = \u22127.66, 95%CI = \u221212.33 to \u22122.99,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001), and increased MEP amplitudes (Fix, MD = 0.45, 95%CI = 0.04\u20130.87,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03). Subgroup analysis of the BBS showed that cTMS had a significant effect on patients with stroke in the subacute phase (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.00001), with improvements observed using HF\u2010rTMS (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001), iTBS (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.00001), and intensities \u2264 80%RMT (&lt; 80% RMT,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001; 80% RMT,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.00001). cTMS consistently demonstrated superior effects compared to controls across different intervention durations (5\u201310 sessions,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.009; 11\u201320 sessions,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.00001; &gt; 20 sessions,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.00001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>cTMS effectively improves motor function in patients with stroke, particularly during the subacute phase with excitatory stimulation and moderate intensities (\u2264 80%RMT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO number: CRD42024540604<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.70471","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T11:34:57Z","timestamp":1744976097000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Cerebellar Transcranial Magnetic Stimulation on the Motor Function of Patients With Stroke: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0065-2505","authenticated-orcid":false,"given":"Yongxin","family":"Zhu","sequence":"first","affiliation":[{"name":"Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine Tongji University  Shanghai China"},{"name":"Shanghai University of Sport  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5525-8522","authenticated-orcid":false,"given":"Juncong","family":"Yang","sequence":"additional","affiliation":[{"name":"Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine Tongji University  Shanghai China"},{"name":"Shanghai University of Sport  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine Tongji University  Shanghai China"},{"name":"Kunshan Rehabilitation Hospital  Kunshan Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianwen","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine Tongji University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahui","family":"Ling","sequence":"additional","affiliation":[{"name":"Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine Tongji University  Shanghai China"},{"name":"Shanghai University of Sport  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xie","family":"Wu","sequence":"additional","affiliation":[{"name":"Shanghai University of Sport  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianhui","family":"Fu","sequence":"additional","affiliation":[{"name":"Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine Tongji University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4286-7679","authenticated-orcid":false,"given":"Qi","family":"Qi","sequence":"additional","affiliation":[{"name":"Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine Tongji University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02507-0"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.3834-03.2004"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1000496107"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2013.03.003"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.4283\/JMAG.2017.22.4.625"},{"issue":"5","key":"e_1_2_9_8_1","first-page":"402","article-title":"The Effects of Supplementing Theta Burst Stimulation of the Cerebellum With Physical Therapy on Balance and Gait Recovery After a Stroke: A Randomized Clinical Trial","volume":"45","author":"Chen J.","year":"2023","journal-title":"Chinese Journal of Physical Medicine and Rehabilitation"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v2.i8.316"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fncir.2021.655502"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1107904108"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-017-0686-6"},{"issue":"13","key":"e_1_2_9_13_1","first-page":"1797","article-title":"Effect of Contralesional Cerebellar iTBS Combined With Routine Rehabilitation on Lower Limb Walking Function in Stroke Patients","volume":"40","author":"Deng L. Y.","year":"2024","journal-title":"Journal of Practical Medicine"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545968308315997"},{"issue":"6","key":"e_1_2_9_15_1","first-page":"688","article-title":"Effects of Repetitive Transcranial Magnetic Stimulation of the Cerebellum on Walking Disorder, Balance Function, and Magnetic Resonance Spectroscopy Indexes in Patients With Ischemic Stroke","volume":"33","author":"Ding X. C.","year":"2022","journal-title":"Hainan Medical Journal"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13105"},{"issue":"6","key":"e_1_2_9_17_1","first-page":"352","article-title":"Effect of Cerebellar Low Frequency rTMS on Lower Lamb Motor Function and Cortical Excitability in Patients With Posterior Circulation Stroke","volume":"10","author":"Duan Q.","year":"2020","journal-title":"Chinese Journal of Brain Diseases and Rehabilitation"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000180861.54180.FF"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2017.11.018"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756286419878317"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2017.11.015"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2013.05.014"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00252-0"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2018.1468932"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1310\/tsr2103-197"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2007.06.026"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0141284"},{"issue":"17","key":"e_1_2_9_28_1","first-page":"2107","article-title":"Clinical Observation on Low Frequency Repetitive Transcranial Magnetic Stimulation for the Treatment of Balance Disorders After Cerebellar Infarction","volume":"15","author":"Hu X. H.","year":"2017","journal-title":"Chinese Journal of Integrative Medicine on Cardio\u2010\/Cerebrovascular Disease"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.5535\/arm.22058"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2019.09.003"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-1802"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.3639"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2008.08.008"},{"issue":"3","key":"e_1_2_9_34_1","first-page":"226","article-title":"Intermittent Theta Burst Stimulation of the Cerebellum Can Improve the Walking of Stroke Survivors With Lower Limb Dysfunction","volume":"46","author":"Kong Q.","year":"2024","journal-title":"Chinese Journal of Physical Medicine and Rehabilitation"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2019.11.002"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.1158"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545968320971735"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.044892"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12061348"},{"issue":"01","key":"e_1_2_9_40_1","first-page":"45","article-title":"Implications of New Findings on Functions of the Cerebellum for Motor Skill Learning and Performance From Neuroscience Perspectives","volume":"56","author":"Liu Z.","year":"2020","journal-title":"China Sport Science and Technology"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27919"},{"issue":"4","key":"e_1_2_9_42_1","first-page":"146","article-title":"Analysis of the Effect of Repetitive Transcranial Magnetic Stimulation of the Cerebellum on the Balance Function of Stroke Patients","volume":"2","author":"Mao J. N.","year":"2021","journal-title":"RARM"},{"issue":"10","key":"e_1_2_9_43_1","first-page":"574","article-title":"The Effect of Cerebellar Transcranial Magnetic Stimulation on Balance and Motor Function in Patients With Hemiplegia Following Stroke","volume":"19","author":"Mao J. N.","year":"2024","journal-title":"Neural Injury and Functional Reconstruction"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neures.2019.01.012"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.23736\/S1973-9087.19.05363-2"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10122401"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhp157"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-13079-8"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2010.10.003"},{"issue":"1","key":"e_1_2_9_50_1","first-page":"21","article-title":"Effects of Intermittent Theta Short Burst Pulse Stimulation to the Cerebellum Vermis on Lower Limb Motor Dysfunction in Stroke Patients","volume":"20","author":"Peng J.","year":"2024","journal-title":"Neural Injury and Functional Reconstruction"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2015.04.069"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn1953"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2017.06.048"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2014.07.013"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-022-01205-y"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bht356"},{"issue":"20","key":"e_1_2_9_57_1","first-page":"119","article-title":"Clinical Observation on Cluster Needling of Scalp Points Combined With Repeated Transcranial Magnetic Stimulation in Treating Balance Disorder After Cerebellar Infarction","volume":"19","author":"Shan X. C.","year":"2022","journal-title":"China Medical Herald"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2016.08.010"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.1455"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410370603"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1177\/15459683231209154"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-022-01062-y"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-024-03720-1"},{"issue":"10","key":"e_1_2_9_64_1","first-page":"1205","article-title":"Effects of Cerebellar Theta\u2010Burst Stimulation on Lower Extremity Motor Function in Stroke Patients","volume":"28","author":"Wang S. R.","year":"2022","journal-title":"Chinese Journal of Rehabilitation Theory and Practice"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1097\/00019052-200412000-00013"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000030302"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2021.688569"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-024-01660-7"},{"key":"e_1_2_9_69_1","first-page":"605","article-title":"The Effect of Cerebellar Repetitive Transcranial Magnetic Stimulation on Balance Function in Stroke Patients","volume":"33","author":"Zhang J. J.","year":"2019","journal-title":"Medical Journal of Communications"},{"key":"e_1_2_9_70_1","first-page":"1","article-title":"The Effect and Optimal Parameters of Repetitive Transcranial Magnetic Stimulation on Lower Extremity Motor Function in Stroke Patient: A Systematic Review and Meta\u2010Analysis","author":"Zhang W.","year":"2023","journal-title":"Disability and Rehabilitation"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.23736\/S1973-9087.24.08307-2"}],"container-title":["Brain and Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.70471","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T08:44:03Z","timestamp":1759135443000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/brb3.70471"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":70,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/brb3.70471"],"URL":"https:\/\/doi.org\/10.1002\/brb3.70471","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1002\/BRB3.70471\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70471\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70471\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70471\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70471\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70471\/v1\/decision1","asserted-by":"object"}]},"ISSN":["2162-3279","2162-3279"],"issn-type":[{"value":"2162-3279","type":"print"},{"value":"2162-3279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2025-01-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70471"}}