rTMS provides modest symptomatic Benefits in patients with Parkinson's disease




TMS Solutions Staff on Apr 12, 2017 12:56:00 PM
TMS Solutions Staff

 

Authors:

Cohen OS; Orlev Y; Yahalom G; Amiaz R; Nitsan Z; Ephraty L; Rigbi A; Shabat C; Zangen A; Hassin-Baer S. Institution Cohen,Oren S. Parkinson Disease and Movement Disorders Institu te, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Avi v University, Tel-Aviv, Israel. Electronic address: oren.cohen@sheba.health.gov.il . Orlev,Yael. Parkinson Disease and Movement Disorders Institut e, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Israel. Yahalom,Gilad. Parkinson Disease and Movement Disorders Insti tute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Avi v University, Tel-Aviv, Israel. Amiaz,Revital. Sackler Faculty of Medicine, Tel-Aviv University, Tel- Aviv, Israel; Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Israel. Nitsan,Zeev. Barzilai Medical Center, Ashkelon, Israel. Ephraty,Lilach. Parkinson Disease and Movement Disorders Insti tute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Israel. Rigbi,Amihai. Department of Behavioral Sciences Kinneret Academic College on the Sea of Galilee, Israel. Shabat,Chen. Parkinson Disease and Movement Disorders Institut e, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Israel. Zangen,Abraham. Department of Life Sciences, Ben-Gurion University, Beer-Sheba, Israel. Hassin-Baer,Sharon. Parkinson Disease and Movement Disorders I nstitute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Med ical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Avi v University, Tel-Aviv, Israel. Tit le Repetitive deep transcranial magnetic stimulation for motor sympto ms in Parkinson's disease: A feasibility study. Source Clinical Neurology & Neurosurgery. 140:73-8, 2016 Jan.

Abstract OBJECTIVES:

Repetitive transcranial magnetic stimulation (rTMS), using standard coils, provided modest symptomatic benefits in patien ts with Parkinson's disease (PD). In our previous exploratory studi es, using the newly developed Hesed coil (providing deeper rTMS; rDTMS) high frequency (HF), excitatory rDTMS over the primary motor cortex (M1), di d not achieve sufficient beneficial effect for PD symptoms, while low frequency (LF) inhibitory stimulation, was mildly beneficial. To further in vestigate the optimal rDTMS stimulation parameters for PD patients, and to assess whether there is an added value for dual stimulation, consis ting of HF rDTMS over the prefrontal cortex (PFC) along with LF M1 rDTMS. The rational for the selection of the current stimulation parameters and sites lies on the previous studies that demonstrated an inhibitor y effect of 1Hz rTMS on the increased cortical activity in PD as well as dopami ne release by PFC stimulation.

PATIENTS AND METHODS:

An open comparative active study of one mo nth duration (12 sessions) of LF rDTMS over M1 alone (n=9) or combined with HF PFC rDTMS (M1-PFC, n=10). Outcome measures included the total an d motor Unified Parkinson's Disease Rating Scale scores (T-UPDRS and M-UPDRS) and other variables, were collected at baseline and on days 30 and 60 . RESULTS: For the M1+PFC group, T-UPDRS score improved from baseline t o day 30, by 15% (median: 52 points, decreased to 44, p=0.02, effect size: 0.51) and M-UPDRS score improved by 24% (median: 37 points decreased to 2 8, p=0.04, effect size: 0.47). The corresponding results for t he M1 group were insignificant. Additionally, the between groups compari son, was insignificant. CONCLUSION: rDTMS, consisting of M1 excitation with PFC inhi bition improved PD motor symptoms but was not significantly superio r to M1 rDTMS alone. rDTMS stimulation protocols for M1 should be furth er evaluated in larger scale controlled studies.Copyright © 2015 Elsevier B.V. All rights reserved.

Authors:

Flamez A; Cordenier A; De Raedt S; Michiels V; Smetcoren S; Van Merhaegen-Wieleman A; Parys E; De Keyser J; Baeken C. Title Bilateral low frequency rTMS of the primary motor cortex may n ot be a suitable treatment for levodopa-induced dyskinesias in late st a ge Parkinson's disease. Source Parkinsonism & Related Disorders. 22:54-61, 2016 Jan.

Topic of this Article:

Topics: rTMS, Parkinson's


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