Efficacy of cerebellar transcranial magnetic stimulation in spinocerebellar ataxia type 3: a randomized, single-blinded, controlled trial

Effects of cerebellar repetitive transcranial magnetic stimulation plus physiotherapy in spinocerebellar ataxias – A randomized clinical trial

“…Gait speed is also included in the international cerebellar ataxia rating scale (ICARS), which may be an explanation for previously reported improvements in this subdomain. 11 , 20 ICARS was not included as outcome measure in our study, so comparison of study results is limited. Furthermore, our study did not show significant changes in objective measurement of postural control.…”

“…Again, this finding is internally consistent with the SARA trunc subscore reported in our study, but with a discrepancy with the reported effects of rTMS on the ICARS gait and balance subscore. 11 , 20 …”

“…Shi and colleagues also found a significant improvement in PATA rate after inhibitory rTMS and iTBS as compared to sham stimulation. 20 However, the study did not include other speech assessments and SARA item 4 is not reported separately. Other studies either did not include speech disturbance as an outcome measure at all, or failed to show iits improvement.…”

“…This finding is in line with other studies. 11 , 20 The performance of NHPT can be highly heterogeneous even within a subject and likely to produce outliers, for example by dropping a peg. Despite improved appendicular motor function, patients could therefore apparently worsen in NHPT after accidentally dropping a peg.…”

“… 14 , 16 In the past years, a number of studies investigated the effects of cerebellar rTMS on ataxic patients with compelling evidence for, at least temporary, positive influence on the disease course. 17 , 18 , 19 , 20 , 21 , 22 Interestingly, stimulatory and inhibitory cerebellar TMS protocols have been tested in cerebellar ataxias, both with reported positive effects on motor function. 11 , 23 The stimulation protocols used (stimulation frequency and duration), the number of patients and the study design are, however, very heterogeneous.…”