Long Term Repetitive Transcranial Magnetic Stimulation Improve Task Performance in a Patient with Multiple System Atrophy

Abstract

Multiple system atrophy (MSA) is a sporadic neurodegenerative disorder characterized by a combination of Parkinsonism, cerebellar ataxia, and autonomic dysfunction. Patients with predominant parkinsonian features are defined as MSA-P, which is similar to Parkinson's disease (PD), except that they are not well responsive to levodopa. Based on the facts that there is no effective treatment for MSA-P .

Effects of Non-invasive Brain Stimulation on Multiple System Atrophy: A Systematic Review

“…The results of methodological quality assessment of the included articles were presented in Table 1 . Nine included articles were published between 2013 and 2020, of which three were randomized controlled trials (Benussi et al, 2015 ; Chou et al, 2015 ; Wang et al, 2016 ; Song et al, 2020 ), two were controlled trials (Kawashima et al, 2013 ; Yildiz et al, 2018 ), two were case report (Wang et al, 2017 ; Alexoudi et al, 2020 ) and one was non-controlled trial (Liu et al, 2018 ).…”

“…Among the nine articles explored the therapeutic effect of NIBS on MSA, rTMS was applied in six articles (Chou et al, 2015 ; Wang et al, 2016 , 2017 ; Liu et al, 2018 ; Yildiz et al, 2018 ; Song et al, 2020 ), and tDCS was applied in two studies (Benussi et al, 2015 ; Alexoudi et al, 2020 ), the paired associative stimulation (PAS) was used in the remaining one (Kawashima et al, 2013 ). Stimulation site was left primary motor cortex (M1) in four articles (Kawashima et al, 2013 ; Chou et al, 2015 ; Wang et al, 2016 , 2017 ), cerebellum in two articles (Yildiz et al, 2018 ; Song et al, 2020 ), and one study simulated both cerebellum and bilateral M1 (Liu et al, 2018 ). High frequency stimulation ranged from 5 to 50 hz was performed in five articles (Chou et al, 2015 ; Wang et al, 2016 , 2017 ; Liu et al, 2018 ; Song et al, 2020 ), and low frequency stimulation between 0.2 and 1 hz was performed in two articles (Kawashima et al, 2013 ; Yildiz et al, 2018 ).…”

“…Stimulation site was left primary motor cortex (M1) in four articles (Kawashima et al, 2013 ; Chou et al, 2015 ; Wang et al, 2016 , 2017 ), cerebellum in two articles (Yildiz et al, 2018 ; Song et al, 2020 ), and one study simulated both cerebellum and bilateral M1 (Liu et al, 2018 ). High frequency stimulation ranged from 5 to 50 hz was performed in five articles (Chou et al, 2015 ; Wang et al, 2016 , 2017 ; Liu et al, 2018 ; Song et al, 2020 ), and low frequency stimulation between 0.2 and 1 hz was performed in two articles (Kawashima et al, 2013 ; Yildiz et al, 2018 ). The duration of intervention varied from single session to 2 weeks.…”

“…Wang et al ( 2016 , 2017 ) adopted an intervention protocol that was almost identical to Chou et al ( 2015 ). The case report of Wang et al ( 2017 ) showed a significant improvement in UPDRS-III and finger tapping, hand alternating, and heel tapping performance (Wang et al, 2017 ). Additionally, central motor conduct time of both sides were shortened after rTMS stimulation in comparison with baseline.…”

“…CMCT is the time it takes for nerve impulses to reach the target muscles based on the central nervous system. Since the CMCT decreased after the high-frequency rTMS treatment, the improvement in trans-synaptic efficiency might be reflected (Wang et al, 2017 ).…”