Multifocal repetitive TMS for motor and mood symptoms of Parkinson disease

Bryś, Mirosław; Fox, Michael; Agarwal, Shashank; Biagioni, Milton; Dacpano, Geraldine; Kumar, Pawan; Pirraglia, Elizabeth; Chen, Robert; Wu, Allan D.; Fernández, Hubert H.; Shukla, Aparna Wagle; Lou, Jau Shin; Gray, Zachary; Simon, David K.; Rocco, Alessandro Di; Pascual‐Leone, Álvaro

doi:10.1212/wnl.0000000000003279

Cited by 136 publications

(143 citation statements)

References 31 publications

(41 reference statements)

Supporting

Mentioning

137

Contrasting

Unclassified

Order By: Relevance

“…rTMS was evaluated in 2 new high‐quality studies for the treatment of depression in PD, which were discrepant regarding depression outcome . Therefore, there is insufficient evidence for rTMS to be rated for the treatment of depression in PD.…”

Section: Results and Conclusionmentioning

confidence: 99%

Update on treatments for nonmotor symptoms of Parkinson's disease—an evidence‐based medicine review

et al. 2019

View full text Add to dashboard Cite

Objective To update evidence‐based medicine recommendations for treating nonmotor symptoms in Parkinson's disease (PD). Background The International Parkinson and Movement Disorder Society Evidence‐Based Medicine Committee's recommendations for treatments of PD were first published in 2002, updated in 2011, and now updated again through December 31, 2016. Methods Level I studies testing pharmacological, surgical, or nonpharmacological interventions for the treatment of nonmotor symptoms in PD were reviewed. Criteria for inclusion and quality scoring were as previously reported. The disorders covered were a range of neuropsychiatric symptoms, autonomic dysfunction, disorders of sleep and wakefulness, pain, fatigue, impaired olfaction, and ophthalmologic dysfunction. Clinical efficacy, implications for clinical practice, and safety conclusions are reported. Results A total of 37 new studies qualified for review. There were no randomized controlled trials that met inclusion criteria for the treatment of anxiety disorders, rapid eye movement sleep behavior disorder, excessive sweating, impaired olfaction, or ophthalmologic dysfunction. We identified clinically useful or possibly useful interventions for the treatment of depression, apathy, impulse control and related disorders, dementia, psychosis, insomnia, daytime sleepiness, drooling, orthostatic hypotension, gastrointestinal dysfunction, urinary dysfunction, erectile dysfunction, fatigue, and pain. There were no clinically useful interventions identified to treat non‐dementia‐level cognitive impairment. Conclusions The evidence base for treating a range of nonmotor symptoms in PD has grown substantially in recent years. However, treatment options overall remain limited given the high prevalence and adverse impact of these disorders, so the development and testing of new treatments for nonmotor symptoms in PD remains a top priority. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

show abstract

Section: Results and Conclusionmentioning

confidence: 99%

Update on treatments for nonmotor symptoms of Parkinson's disease—an evidence‐based medicine review

et al. 2019

View full text Add to dashboard Cite

show abstract

“…There was insufficient information to categorize the blind procedure in two studies (del Olmo et al., ; Sedlackova et al., ). Nine studies (Benninger et al., , ; Brys et al., ; Hamada et al., ; Khedr et al., ; Kim et al., ; Lomarev et al., ; Sedlackova et al., ; Shirota et al., ) described the dropout number.…”

Section: Resultsmentioning

confidence: 99%

“…Brys et al. () reported adverse effects in 25 active rTMS and nine sham rTMS‐treated PD patients, respectively. The most common adverse effects were mild and transient headache and neck pain.…”

Section: Resultsmentioning

confidence: 99%

“…Optimal parameters, however, have yet to be established. For example, many studies used rTMS protocols varying in stimulation parameters such as (a) stimulation sites of primary motor cortex (M1; Benninger et al., ; Bornke, Schulte, Przuntek, & Muller, ; Brys et al., ; Filipovic, Rothwell, van de Warrenburg, & Bhatia, ; Flamez et al., ; Khedr, Farweez, & Islam, ; Khedr, Rothwell, Shawky, Ahmed, & Hamdy, ; Kim et al., ; Lefaucheur et al., ; Maruo et al., ; Okabe, Ugawa, & Kanazawa, ; Siebner, Rossmeier, Mentschel, Peinemann, & Conrad, ; Yokoe et al., ) supplementary motor area (SMA; Brusa et al., ; Eggers, Günther, Rothwell, Timmermann, & Ruge, ; Hamada, Ugawa, & Tsuji, ; Koch et al., ; Shirota, Ohtsu, Hamada, Enomoto, & Ugawa, ; Yokoe et al., ) dorsal lateral prefrontal cortex (DLPFC; Brys et al., ; del Olmo, Bello, & Cudeiro, ; Nardone et al., ; Sedlackova, Rektorova, Srovnalova, & Rektor, ; Yokoe et al., ) the dorsal premotor (PMD; Sedlackova et al., ) and M1+ DLPFC (The M1+ DLPFC stimulation was considered as complex region stimulation; Benninger et al., ; Brys et al., ; Lomarev et al., ;) (b) LF‐rTMS (from 0.2 Hz to 1.0 Hz; Brusa et al., ; Filipovic et al., ; Flamez et al., ; Koch et al., ; Lefaucheur et al., ; Nardone et al., ; Okabe et al., ; Shirota et al., ) or HF‐rTMS (5.0 Hz: Hamada et al., ; Khedr et al., ; Koch et al., ; Siebner et al., , 10.0 Hz: Bornke et al., ; Brys et al., ; del Olmo et al., ; Khedr et al., ; Kim et al., ; Lefaucheur et al., ; Maruo et al., ; Shirota et al., ; Sedlackova et al., ; Yokoe et al., , 25.0 Hz: Lomarev et al., and 50.0 Hz: Benninger et al., ); (c) rTMS sessions: (one session: Bornke e...…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Repetitive transcranial magnetic stimulation therapy for motor recovery in Parkinson's disease: A Meta‐analysis

et al. 2018

View full text Add to dashboard Cite

IntroductionTherapeutic effects of repetitive transcranial magnetic stimulation (rTMS) on motor recovery of Parkinson's disease (PD) have been reported; however, the protocols of these studies varied greatly. The aim of this meta‐analysis was to evaluate the optimal rTMS parameters for motor recovery of PD.MethodsElectronic databases were searched for studies investigating the therapeutic effects of rTMS on motor function in patients with PD. The section III of the Unified Parkinson's Disease Rating Scale (UPDRS) was extracted as the primary outcome, and the standardized mean difference (SMD) with 95% confidence interval (CI) was calculated.ResultsTwenty‐three studies with a total of 646 participants were included. The pooled estimates of rTMS revealed significant short‐term (SMD, 0.37; p < 0.00001) and long‐term (SMD, 0.39; p = 0.005) effects on motor function improvement of PD. Subgroup analysis observed that high‐frequency rTMS (HF‐rTMS) was significant in improving motor function (SMD, 0.48; p < 0.00001), but low‐frequency rTMS (LF‐rTMS) was not. In particular, when HF‐rTMS targeted over the primary motor cortex (M1), in which the bilateral M1 revealed a larger effect size than unilateral M1. Compared to single‐session, multi‐session of HF‐rTMS over the M1 showed significant effect size. In addition, HF‐rTMS over the M1 with a total of 18,000–20,000 stimulation pulses yielded more significant effects (SMD, 0.97; p = 0.01) than other dosages.ConclusionsIn conclusion, multi‐session of HF‐rTMS over the M1 (especially bilateral M1) with a total of 18,000–20,000 pulses appears to be the optimal parameters for motor improvement of PD.

show abstract

“…A single photon emission computed tomography study showed that high‐frequency rTMS led to similar changes as antidepressant fluoxetine with increased regional cerebral blood flow in posterior cingulate gyrus and decreased regional cerebral blood flow in the right medial frontal gyrus . However, some studies showed that neither 10‐Hz rTMS over bilateral DLPFC nor 10‐Hz rTMS to both M1 and DLPFC ameliorate mood symptoms in patients with PD. The relatively short treatment duration may partly explain the negative findings.…”

Section: Noninvasive Brain Stimulation In Pdmentioning

confidence: 99%

Invasive and Noninvasive Brain Stimulation in Parkinson's Disease: Clinical Effects and Future Perspectives

Chen

2019

Clin Pharma and Therapeutics

Self Cite

View full text Add to dashboard Cite

In this review, we discuss the clinical and electrophysiological effects and the future directions of invasive and noninvasive brain stimulations in Parkinson's disease (PD). Deep brain stimulation (DBS) can improve motor symptoms in moderate to advanced PD. However, the optimal stimulation paradigm for nonmotor symptoms (NMS), freezing of gait, and the optimal timing of DBS are still under investigation. The findings of pathological oscillations and abnormal frequency to amplitude coupling provide models to develop adaptive DBS. Transcranial magnetic stimulation (TMS) revealed abnormal cortical excitability and plasticity in PD. Consecutive sessions of high‐frequency, repetitive TMS on the motor cortex showed promising results. Paired TMS and DBS at specific times provided a novel way to investigate PD pathophysiology and have potential as a future treatment. Transcranial direct current stimulation or transcranial alternating current stimulation with multifocal electrodes or at specific phases of oscillation are also potential future strategies.

show abstract

Multifocal repetitive TMS for motor and mood symptoms of Parkinson disease

Cited by 136 publications

References 31 publications

Update on treatments for nonmotor symptoms of Parkinson's disease—an evidence‐based medicine review

Update on treatments for nonmotor symptoms of Parkinson's disease—an evidence‐based medicine review

Repetitive transcranial magnetic stimulation therapy for motor recovery in Parkinson's disease: A Meta‐analysis

Invasive and Noninvasive Brain Stimulation in Parkinson's Disease: Clinical Effects and Future Perspectives

Contact Info

Product

Resources

About