Document Detail


Intermittent theta-burst transcranial magnetic stimulation for treatment of Parkinson disease.
MedLine Citation:
PMID:  21321333     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  Neurology     Volume:  76     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-15     Completed Date:  2011-04-01     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  601-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
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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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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