Therapeutic effect of repetitive transcranial magnetic stimulation on motor function in Parkinson's disease patients.
Author: Khedr EM, Farweez HM, Islam H.
Source:
European Journal of Neurology, 10(5), 567-572.
Cortical excitability of the primary motor cortex is altered in patients with
Parkinson's disease (PD). Therefore, modulation of cortical excitability by high
frequency repetitive transcranial magnetic stimulation (rTMS) of the motor cortex
might result in beneficial effects on motor functions in PD. The present study
aims to evaluate the effect of rTMS of the motor cortex on motor functions in
patients with PD. Thirty-six unmedicated PD patients were included consecutively
in this study. The patients were assigned in a randomized pattern to one of two
groups, one group receiving real-rTMS (suprathreshold 5-Hz, 2000 pulses once a
day for 10 consecutive days) and the second group receiving sham-rTMS using
closed envelopes. Total motor section of Unified Parkinson's Disease Rating Scale
(UPDRS), walking speed, and self-assessment scale were performed for each patient
before rTMS and after the first, fifth, 10th sessions, and then after 1 month.
Evaluation of these measures was performed blindly without knowing the type of
rTMS. anova for repeated measurements revealed a significant time effect for the
total motor UPDRS, walking speed and self-assessment scale during the course of
the study in the group of patients receiving real-rTMS (P = 0.0001, 0.001, and
0.002), while no significant changes were observed in the group receiving
sham-rTMS except in self-assessment scale (P = 0.019). A 10-day course of
real-rTMS resulted in statistically significant long-term improvement of the
motor functions in comparison with the sham-rTMS. The rTMS could have a
therapeutic role of for PD patients.