Single Session Intermittent Theta-Burst Stimulation on the Left Premotor Cortex Does Not Alleviate Freezing of Gait in Parkinson's Disease




Curated By TMS Solutions on Jun 11, 2017 12:00:00 AM
Curated By TMS Solutions

TITLE
Single Session Intermittent Theta-Burst Stimulation on the Left Premotor Cortex Does Not Alleviate Freezing of Gait in Parkinson's Disease

AUTHORS
Tard C; Devanne H; Defebvre L; Delval A. Institution Tard, Celine. Universite de Lille, U1171 troubles cognitifs, degeneratifs et vasculaires, Lille, France; Service de Neurologie et Pathologie du mouvement, Hopital Roger Salengro, CHU de Lille, Lille, France; Service de Neurophysiologie Clinique, Hopital Roger Salengro, CHU de Lille, Lille, France.  Devanne, Herve. Service de Neurophysiologie Clinique, Hopital Roger Salengro, CHU de Lille, Lille, France; Universite du Littoral Cote d'Opale, Calais, France. Defebvre, Luc. Universite de Lille, U1171 troubles cognitifs, degeneratifs et vasculaires, Lille, France; Service de Neurologie et Pathologie du mouvement, Hopital Roger Salengro, CHU de Lille, Lille, France. Delval, Arnaud. Universite de Lille, U1171 troubles cognitifs, degeneratifs et vasculaires, Lille, France; Service de Neurophysiologie Clinique, Hopital Roger Salengro, CHU de Lille, Lille, France.

ELECTRONIC ADDRESS
arnaud.delval@chru-lille.fr

SOURCE
Neuroscience Letters. 628:1-9, 2016 Aug 15.

OBJECTIVE
To investigate the efficiency of intermittent theta-burst stimulation (iTBS) to alleviate the symptoms of freezing of gait (FoG) in Parkinson's disease (PD).

METHODS
We performed a cross-over, sham-controlled study of patients with severe PD, bilateral motor signs and debilitating, severe FoG, that was levodopa-sensitive but not controlled by optimal dopatherapy. We applied iTBS to the left premotor cortex and measured FoG, gait initiation and continuous gait, before and immediately after the iTBS session. All patients received sham and true iTBS with a one-week interval and in randomized order.

RESULTS
15 patients were included in the study. Recordings were performed under usual medication and all patients always showed unresponsive freezing. The pre- and post-stimulation gait trajectories did not differ in terms of the mean trajectory completion time or the percent time with FoG. The percent time with FoG was 6% greater after sham stimulation and 3% lower after iTBS (p>0.05). Visual cueing modified gait initiation and continuous gait but these latter were not influenced by rTMS.

CONCLUSIONS
The present study provides Class I evidence that iTBS of the left premotor cortex does not alleviate FoG in PD.

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Topics: Parkinson's, Theta Burst TMS


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