Effects of transcranial magnetic stimulation on the motor and non-motor symptoms of Parkinson′s disease

Abstract

Objective To explore the effect of repeated transcranial magnetic stimulation (rTMS) combined with rehabilitation training on the motor and non-motor symptoms of Parkinson′s disease. Methods A total of 150 persons with Parkinson′s disease were randomly divided into an rTMS group, a rehabilitation training group and an observation group, each of 50. The rTMS group received only repeated magnetic stimulation. The rehabilitation training group received only standard rehabilitation training. The observation group was given both for 4 weeks. The overall efficacy of each treatment was evaluated using the unified Parkinson′s disease rating scale (UPDRS), while the motor symptoms were assessed using the 10 m back-and-forth run test, a simple test for evaluating hand function (STEF) and Berg′s balance scale. Non-motor symptoms were evaluated using a questionnaire (NMSQ), the mini-mental state examination (MMSE), the Hamilton depression scale (HAMD), the Hamilton anxiety scale (HAMA) and the Parkinson′s disease sleep scale (PDSS). Moreover, a comprehensive quality of life assessment questionnaire (SF-36) was used to evaluate the life quality of patients before and after the treatment. Results Compared with before the treatment, the average UPDRS scores of all three groups were lower after the treatment. Moreover, the average UPDRS score of the observation group was significantly lower than those of the other two groups. Significant improvement was observed in the mean 10 m run time and in the average STEF and Berg scores of the rehabilitation training and observation groups, but not in the rTMS group′s averages. After the treatment, the mean NMSQ, MMSE, HAMD, HAMA and PDSS results of the rTMS and observation groups were significantly better than those before treatment, with the observation group′s averages significantly better than those of the rehabilitation training group. The average PDSS and SF-36 scores of the observation group were also significantly better than those of the other groups. Conclusion rTMS combined with rehabilitation training can significantly improve the motor and non-motor symptoms of Parkinson′s disease patients, and its efficacy is superior to that of rTMS or rehabilitation training alone. Key words: Parkinson′s disease; Transcranial magnetic stimulation; Rehabilitation training