Cerebellar transcranial magnetic stimulation improves motor function in Parkinson's disease

IF 4.4 2区医学 Q1 CLINICAL NEUROLOGY Annals of Clinical and Translational Neurology Pub Date : 2024-09-05 DOI:10.1002/acn3.52183

Marcus Grobe-Einsler, Viktoria Baljasnikowa, Aline Faikus, Tamara Schaprian, Oliver Kaut

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Abstract

Objective

To determine whether an accelerated protocol of 48 Hz cerebellar repetitive transcranial magnetic stimulation results in improved motor function in individuals with Parkinson's disease.

Methods

In this double-blind randomized sham-controlled study, 35 individuals with Parkinson's disease and stable medical treatment were randomized to either sham or verum transcranial magnetic stimulation. The stimulation was applied bilaterally and medial over the cerebellum and comprised a novel accelerated protocol encompassing two sessions per day on 5 consecutive days. Patients were assessed at baseline, on day 5 after the last stimulation and 1 month post intervention. Measurements included dynamic posturography, UPDRS III, 8-Meter walk test, and Timed Up and Go test.

Results

The accelerated protocol was safe and feasible in an outpatient setting. Patients in the verum group showed significant improvement (p < 0.001) of motor symptoms as measured in the UPDRS III. Improvement was mainly carried by the domains rigor, bradykinesia, and gait and persisted after 1 month (p = 0.009), whereas tremor remained unchanged.

Interpretation

The effect of a high-dose transcranial magnetic stimulation in patients with Parkinson's disease is encouraging and comparable to other studies using much longer stimulation protocols. This short-term intervention of 5 days facilitates the future application in an outpatient setting. Reduction in hospitalization rates directly benefits patients with motor impairment.

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小脑经颅磁刺激可改善帕金森病患者的运动功能。

目的：确定 48 赫兹小脑重复经颅磁刺激加速方案是否能改善帕金森病患者的运动功能：确定 48 赫兹小脑重复经颅磁刺激加速方案是否能改善帕金森病患者的运动功能：在这项双盲随机假对照研究中，35 名接受过稳定治疗的帕金森病患者被随机分配接受假或 verum 经颅磁刺激。刺激在双侧小脑内侧进行，采用新的加速方案，每天两次，连续进行5天。患者分别在基线、最后一次刺激后第 5 天和干预后 1 个月接受评估。测量项目包括动态脑电图、UPDRS III、8米步行测试和定时起立行走测试：加速方案在门诊环境中安全可行。verum组患者的病情有了明显改善（p 解释：高剂量经颅磁刺激治疗的效果明显：对帕金森病患者进行大剂量经颅磁刺激的效果令人鼓舞，可与其他使用更长时间刺激方案的研究相媲美。这种为期 5 天的短期干预有利于今后在门诊环境中应用。住院率的降低可使运动障碍患者直接受益。

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来源期刊

Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)

CiteScore

9.10

自引率

1.90%

发文量

218

审稿时长

8 weeks

期刊介绍： Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.