{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:41:58Z","timestamp":1792489318088,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Freezing of gait (FOG) is a disabling and episodic gait disturbance in patients with Parkinson\u2019s, with varying responses to noninvasive brain stimulation. Transcranial magnetic stimulation (TMS) has been explored as a therapeutic option; however, the optimal cortical target for reducing FOG remains unclear. This systematic review synthesizes and critically evaluates the available evidence regarding the effects of TMS applied to different cortical targets on FOG\u2010related outcomes, with emphasis on the indirect nature of comparisons between targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted in four electronic databases (PubMed, Cochrane Library, Web of Science, and Scopus) from inception to December 2025, followed by an updated search conducted through July 21, 2026. Randomized and crossover randomized controlled trials investigating the effects of TMS on FOG in parkinsonism were included. Studies have used TMS with a variety of protocols to target different cortical regions. They evaluated FOG\u2010related outcomes by using validated questionnaires or objective tasks. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Because of heterogeneity in stimulation protocols and outcome measures, a narrative synthesis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The updated search identified additional records; however, no new eligible studies were identified after screening. Therefore, ten studies met the inclusion criteria. Favorable FOG\u2010related findings were reported in some studies targeting the primary motor cortex, including reductions in Freezing of Gait Questionnaire scores and improvements in gait performance, with effects persisting for several weeks in some studies. Findings regarding stimulation of the supplementary motor area were variable, ranging from reported reductions in FOG\u2010related outcomes to limited effects and, in one study, worsening of gait performance. Evidence regarding other targets, including the cerebellum and premotor cortex, was limited and did not demonstrate consistent improvements in FOG\u2010related outcomes. Overall, the included studies reported predominantly mild and transient adverse effects associated with TMS. However, because comparisons between cortical targets were indirect and the included studies demonstrated substantial clinical and methodological heterogeneity, the available evidence does not permit identification of an optimal cortical target for improving FOG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The available randomized evidence suggests that TMS may influence FOG\u2010related outcomes; however, the effects cannot be reliably attributed to the cortical target\u00a0alone. Because no direct head\u2010to\u2010head comparisons between cortical targets were available and the included studies were small and clinically and methodologically heterogeneous, the current evidence is insufficient to identify an optimal or preferred cortical target. Future adequately powered randomized trials directly comparing cortical targets are required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO; registration number CRD420261280646<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70360","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:16:05Z","timestamp":1792487765000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Different Cortical Targets of Transcranial Magnetic Stimulation on Freezing of Gait in Parkinsonism: A Systematic Review"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2154-9404","authenticated-orcid":false,"given":"Magdy","family":"Adel","sequence":"first","affiliation":[{"name":"Faculty of Physical Therapy Benha University  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