| Intermittent theta-burst transcranial magnetic stimulation for treatment of Parkinson disease. | |
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MedLine Citation:
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PMID: 21321333 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate the safety and efficacy of intermittent theta-burst stimulation (iTBS) in the treatment of motor symptoms in Parkinson disease (PD). BACKGROUND: Progression of PD is characterized by the emergence of motor deficits, which eventually respond less to dopaminergic therapy and pose a therapeutic challenge. Repetitive transcranial magnetic stimulation (rTMS) has shown promising results in improving gait, a major cause of disability, and may provide a therapeutic alternative. iTBS is a novel type of rTMS that may be more efficacious than conventional rTMS. METHODS: In this randomized, double-blind, sham-controlled study, we investigated safety and efficacy of iTBS of the motor and dorsolateral prefrontal cortices in 8 sessions over 2 weeks (evidence Class I). Assessment of safety and clinical efficacy over a 1-month period included timed tests of gait and bradykinesia, Unified Parkinson's Disease Rating Scale (UPDRS), and additional clinical, neuropsychological, and neurophysiologic measures. RESULTS: We investigated 26 patients with mild to moderate PD: 13 received iTBS and 13 sham stimulation. We found beneficial effects of iTBS on mood, but no improvement of gait, bradykinesia, UPDRS, and other measures. EEG/EMG monitoring recorded no pathologic increase of cortical excitability or epileptic activity. Few reported discomfort or pain and one experienced tinnitus during real stimulation. CONCLUSION: iTBS of the motor and prefrontal cortices appears safe and improves mood, but failed to improve motor performance and functional status in PD. Classification of evidence: This study provides Class I evidence that iTBS was not effective for gait, upper extremity bradykinesia, or other motor symptoms in PD. |
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Authors:
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D H Benninger; B D Berman; E Houdayer; N Pal; D A Luckenbaugh; L Schneider; S Miranda; M Hallett |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Intramural |
Journal Detail:
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Title: Neurology Volume: 76 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-02-15 Completed Date: 2011-04-01 Revised Date: 2012-02-15 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 601-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurology, University Hospital of Basel, Petersgraben 4, 4051 Basel, Switzerland. benningerd@uhbs.ch |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Double-Blind Method Electroencephalography Electromyography Evoked Potentials, Motor / physiology Female Follow-Up Studies Humans Male Middle Aged Motor Cortex / physiopathology Neuropsychological Tests Parkinson Disease / physiopathology*, therapy* Psychiatric Status Rating Scales Theta Rhythm / physiology* Transcranial Magnetic Stimulation / methods* |
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