Effects of Repetitive Transcranial Magnetic Stimulation on Motor Symptoms in Parkinson Disease

Abstract

IMPORTANCE Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation technique that has been closely examined as a possible treatment for Parkinson disease (PD). However, results evaluating the effectiveness of rTMS in PD are mixed, mostly owing to low statistical power or variety in individual rTMS protocols.OBJECTIVES To determine the rTMS effects on motor dysfunction in patients with PD and to examine potential factors that modulate the rTMS effects.

Transcranial Magnetic Stimulation Treatment for Motor Symptoms in Parkinson’s Disease: A Review of Two Decades of Studies

“…Moreover, many studies were not sham-controlled and for sham-controlled studies, different methods of sham stimulation have been used: tilted [33,37,54,56,60,62], sham [39,47,63] and inactive coils [50,66,68] have been used, as well as occipital stimulation [40,49,61], coil back surface [41] and realistic sham [51,57,58]. A very recent review [69] examined 20 RCTs of rTMS treatment for motor dysfunction in PD to evaluate the efficacy of treatment and identify protocols factors that moderate the effects of treatment. The authors reported a significant medium effect size (standardized mean difference -SMD = 0.46) favoring active rTMS over sham treatment in the reduction of motor symptoms in PD.…”

Low-frequency repetitive transcranial magnetic stimulation (rTMS), a new treatment option in neuropsychiatry

“…The study by Zhu et al, which point to at similar issue concerning the potential of rTMS in the treatment of PD, is supported by another recent meta-analysis by Chou et al (7). In all, 20 shamcontrolled randomised controlled trials with a total of 470 patients were included.…”

Parkinson's disease treatments: focus on transcranial direct current stimulation (tDCS)

“…Therapeutic studies of non-invasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS), have yielded promising results in PD. Two meta-analyses concluded that there was a modest therapeutic effect of rTMS in motor performance in PD, 3,4 with no safety concerns.…”