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Placebo-controlled study of rTMS for the treatment of Parkinson's disease

โœ Scribed by Mikhail P. Lomarev; Sulada Kanchana; William Bara-Jimenez; Meena Iyer; Eric M. Wassermann; Mark Hallett


Publisher
John Wiley and Sons
Year
2005
Tongue
English
Weight
125 KB
Volume
21
Category
Article
ISSN
0885-3185

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โœฆ Synopsis


Abstract

The objective of this study is to assess the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for gait and bradykinesia in patients with Parkinson's disease (PD). In a doubleโ€blind placeboโ€controlled study, we evaluated the effects of 25 Hz rTMS in 18 PD patients. Eight rTMS sessions were performed over a 4โ€week period. Four cortical targets (left and right motor and dorsolateral prefrontal cortex) were stimulated in each session, with 300 pulses each, 100% of motor threshold intensity. Left motor cortex (MC) excitability was assessed using motor evoked potentials (MEPs) from the abductor pollicis brevis. During the 4 weeks, times for executing walking and complex hand movements tests gradually decreased. The therapeutic rTMS effect lasted for at least 1 month after treatment ended. Rightโ€hand bradykinesia improvement correlated with increased MEP amplitude evoked by left MC rTMS after individual sessions, but improvement overall did not correlate with MC excitability. rTMS sessions appear to have a cumulative benefit for improving gait, as well as reducing upper limb bradykinesia in PD patients. Although shortโ€term benefit may be due to MC excitability enhancement, the mechanism of cumulative benefit must have another explanation. ยฉ 2005 Movement Disorder Society


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