Bibliometric and visual analysis of Theta burst transcranial magnetic stimulation

doi:10.12307/2025.701

Abstract

Abstract: BACKGROUND: Compared with conventional repetitive transcranial magnetic stimulation, Theta burst transcranial magnetic stimulation (TBS) has attracted extensive attention from scholars in various fields due to its advantages of short stimulation time, high efficiency, good safety and long-lasting effect, and the research popularity continues to rise.
OBJECTIVE: Through the visual bibliometrics analysis of international TBS research in the past 20 years, to sort out the development context of TBS research, summarize the research status, reveal research hotspots and development trends, and provide reference for subsequent research.
METHODS: Relevant studies on TBS from January 2005 to June 2024 were searched in the Web of Science Core Collection database. CiteSpace software was used to perform annual publication volume analysis, co-occurrence analysis of countries, institutions and authors, and co-citation analysis of references, journals and authors, keywords co-occurrence, clustering, time evolution and emergence analysis, and so on, and draw the visual knowledge map.
RESULTS AND CONCLUSION: (1) After screening, a total of 1914 papers were included in the study, and the amount of TBS research has shown an overall increasing trend over the past 20 years, and it is expected to continue to be a hot topic of research in the future. (2) The top three countries in terms of number of publications are the United States, China and Italy, and the top three institutions are the University of Toronto, the University of London and Harvard Medical School. Pascual-leone Alvaro from Harvard Medical School has the most research achievements, and HUANG YZ from Chang Gung University has the most citations. NEURON is the most influential core journal. (3) Analyses of high-frequency keywords, highly cited references and clustering topics showed that the research hotspots of TBS in the past 20 years mainly focus on the mechanism of TBS on synaptic plasticity and neurophysiological activity, the effect of TBS on stimulating targets in different brain regions (including the motor cortex, dorsolateral prefrontal cortex, anterior cingulate cortex and cerebellum, etc.), and the therapeutic effect of TBS on neurological and psychiatric diseases (including depression, Parkinson’s disease movement disorder, post-stroke movement disorder and cognitive impairment, and Alzheimer’s disease memory disorders). (4)Keyword burst, literature emergence and keyword temporal evolution analyses showed that “major depression, application guidelines, rating scale, efficacy, disorder, refractory depression, meta-analysis, etc.” are not only current research hotspots, but also future research trends. (5) In the future, TBS research should strengthen the regional cooperation of core authors and institutions, explore the clinical application in the treatment of refractory diseases, and realize the precision, personalization and optimization of TBS application by combining cutting-edge technologies and optimizing stimulus parameters, so as to solve more clinical problems.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Theta burst transcranial magnetic stimulation, bibliometrics, CiteSpace, visual analysis, plasticity, long-term potentiation, long-term depression

CLC Number:

Gao Wenyan, Zheng Zhaoyan, Pan Shang, Wang Peipei, Ji Chunhui, Lyu Shaoping. Bibliometric and visual analysis of Theta burst transcranial magnetic stimulation[J]. Chinese Journal of Tissue Engineering Research, 2025, 29(20): 4389-4400.

Figures/Tables 15

2.1 TBS研究年度发文量分析由于2024年的数据尚未完全统计，文章仅分析了2005-2023年TBS相关文献的发文量。如图1所示，2005-2015年发文量稳步上升，这一时期TBS应用处于起步阶段并逐渐受到关注；2016-2018年发文量短暂下降；2018年后，发文量开始大幅增长，TBS进入快速发展阶段，2022年达最大值205篇。趋势线显示，拟合方程y=10.24x-20 527，R2=0.936 4(R2越接近1，拟合效果越好)，2005-2023年TBS发文量在趋势线周围上下波动，2023年回落趋势线上，预测未来发文量将继续增加。 2.2 TBS研究国家共现合作分析国家网络图谱共包括65个节点和102条连线，网络密度为0.049，见图2。其中，美国、中国、意大利等在2005年便开始关注TBS研究并持续至今，起步较早。如表1所示，美国(505篇)发文量最多，中国(352篇)、意大利(274篇)紧随其后。葡萄牙(0.72)、法国(0.65)、波兰(0.45)中心性较高，国家间合作较频繁。总体来看，区域间形成了以中国为枢纽的中国、西班牙、英国合作网络，以及以美国、加拿大为代表的北美国家与以葡萄牙、法国、奥地利为代表的欧洲国家的紧密合作网络，显示了国际TBS研究的区域性分布和密切合作关系。 2.3 TBS研究机构共现合作分析机构网络图谱共包括507个研究机构，构成2 027条合作关系，网络密度为0.015 8，见图3。其中，加拿大多伦多大学(97篇)发文量最多，其次为英国伦敦大学(83篇)和美国哈佛大学医学院(52篇)。同时这3所大学的中心性也最高，在网络中起桥梁作用，见表2。整体来看，发文量前10位的机构以各国大学为主，占比90%，机构间形成了以多伦多大学、伦敦大学和哈佛大学医学院为枢纽的紧密且频繁的合作网络，且这些机构大多来自北美和欧洲等发达国家，与国家合作网络所示结果一致。 2.4 TBS研究核心作者分析作者共现图谱共包括701名学者，形成1 757条合作关系，网络密度为0.007 2，见图4。哈佛大学医学院的Pascual-Leone，Alvaro以52篇论文居首位，伦敦大学的Rothwell，John C和罗马大学的Berardelli，Alfredo紧随其后，主要自北美和欧洲等发达国家，与机构共现结果一致，见表3。然而，所有作者中心性值均 < 0.1，相比于国家和机构的合作模式，多呈现相对均匀的合作关系，缺乏枢纽性的核心作者。利用普莱斯定律公式：M=0.749×√ Nmax，计算显示M=5.4，说明发文量≥6篇为该领域核心作者，文章共64名核心作者，论文量为888篇，占总量的40.3%，虽接近普莱斯定律的50%标准，但仍说明TBS研究的核心学者群尚未形成。作者共被引图谱共包括981个节点和8 416条连线，网络密度为0.017 5，见图5。其中，被引频次最高的是中国长庚大学的HUANG YZ教授(1 173次)，罗马生物医学自由大学的DILAZZARO V教授(506次)和锡耶纳大学的ROSSI S教授(475次)位列第2，3位，见表3。然而，仅新西兰奥塔哥大学的ABRAHAM WC中心性 > 0.1，对此关键节点进一步研究发现，ABRAHAM WC的研究主要涉及突触可塑性、长时程增强和长时程抑制等内容，说明TBS相关神经调节机制的研究是后续研究的基础。 2.5 文献共被引、聚类和突现分析文献共被引图谱共包含1 258篇文献和5 941条连线，网络密度为0.007 5，见图6。其中，被引频次前10位的文献类型包括5篇综述[15-19]、5项临床"

试验[1，5，20-22]，见表4。综述性研究通过总结现有证据，可为后续研究提供参考基础，而临床试验则直接提供权威数据并指导实际应用，因此两者引用较为频繁。BLUMBERGER等[5]发表在《LANCET》的一项随机对照试验被引用184次，居首位。LEFAUCHEUR等[17]基于以往研究更新了rTMS的应用指南，被引用139次，位列第二。然而，仅2篇文献中心性值 > 0.1，分别是HAMADA等[20]关于不同TBS方案与运动诱发电位潜伏期相关性的随机对照试验，以及NETTEKOVEN等[23]关于不同iTBS脉冲量对皮质兴奋性和功能连接影响的研究。总之，以上关键节点的内容说明，TBS治疗抑郁症等精神疾病的疗效仍是研究重点，而系统化的应用指南也备受关注，TBS的作用机制和原理则是其他研究开展的基础，与其他研究共同引用最为密切。文献共被引聚类图谱共显示8个聚类群，分别是：#0抑郁症(代表文献BLUMBERGER等[5])、#1可塑性(代表文献HAMADA等[20])、#2大脑皮质(代表文献ROSSI等[19])、#3脑卒中(代表文献TALELLI等[24])、#4小脑(代表文献KOCH等[25])、#5 Meta分析(代表文献LOWE等[26])、#6帕金森病(代表文献KOCH等[27])、#7康复(代表文献TALELLI等[28])，见图7。图中，Q值=0.739 0 > 0.3，S值=0.886 8 > 0.7，说明文献聚类结构显著且可信。文献突现指某文献在特定时段内被频繁引用，通常反映领域内新的研究热点或重要发现。如图8所示，近20年内最早出现突现的是HUANG等[1]于2005年发表的一项临床试验，突现强度为56.32，位居首位。在2007年，该团队的另一项随机对照试验突现持续时间最长，为5年[21]。LEFAUCHEUR等[17]在2020年发表的rTMS应用指南突现年份最晚，并持续至今。 2.6 期刊共被引和双图叠加分析期刊共被引图谱共包括878个节点和8 049条连线，网络密度为0.020 9，见图9。《NEURON》(1 490次)被引频次最高，其次是《CLIN NEUROPHYSIOL》(1 334次)和《J NEUROSCI》(1 333次)。其中《NEURON》影响因子(IF=14.7)"

和被引频次均最高，在TBS领域有重要学术影响力，这表明TBS研究主要集中在神经学领域。然而，期刊中心性值均 < 0.1，说明TBS研究在不同学术期刊上的知识传播较为分散，见表5。基于Journal Citation Reports 2011地图对期刊进行双图叠加，见图10。图中主要存在3条突出引用路径，其中分子学、生物学、免疫学(黄色轨迹)出版物明显受分子学、生物学、遗传学(z=3.67，f=3 188)和心理学、教育学、社会学(z=2.58，f=2 335)的影响；神经学、运动学、眼科学(粉色轨迹)则受分子学、生物学、遗传学(z=3.31，f=2 906)和心理学、教育学、社会学(z=3.40，f=2 973)出版物的影响，这两条路径展示了TBS领域的多学科交叉发展模式。此外，被引集团的心理学、教育学、社会学(z=2.08，f=1 944)表现为向施引集团的心理学、教育学、健康学(蓝色轨迹)领域的独立发展趋势，这表明TBS研究的知识流动呈多样化，未来应重视多学科合作与发展。 2.7 TBS研究热点分析 2.7.1 关键词共现和时区图分析关键词共现图谱共包含772个节点和6 164条连线，网络密度为0.020 7，见图11。排除与检索策略相关的主题词：如“经颅磁刺激、Theta爆发式刺激、重复经颅磁刺激”后，热点词包括“运动皮质、可塑性、兴奋性、长时程增强、抑郁症、背外侧前额叶皮质、帕金森病”等，见表6。其中“阿尔茨海默病”中心性最高(0.13)，在网络中起枢纽作用。时区图显示，2005-2013年，研究主要集中在TBS对不同脑区(如运动皮质、前额叶皮质、后顶叶皮质、背外侧前额叶皮质)的不同作用机制(如可塑性、兴奋性、长时程增强、皮质内抑制、脑血流量、功能连接性)及其对各种疾病(如抑郁症、阿尔茨海默病、帕金森病、脑卒中)的影响。2014-2016年“个体间异质性”“电休克疗法”“间歇性Theta爆发刺激”和“连续性Theta爆发刺激”开始引起学者关注；2017-2024年，研究热点则转向“重度抑郁症”和“难治性抑郁症”并关注至今，见图12。"

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