Efficacy of Repetitive Transcranial Magnetic Stimulation on spasticity in Egyptian Multiple Sclerosis Patients

Abstract

Background; One of the most common neurologic disorders is multiple sclerosis. To improve quality of life, many tools have been employed. Repetitive transcranial magnetic stimulation (rTMS) is a new established technique to treat spasticity and improve the outcome of rehabilitation program in various neurologic conditions. Aim and objectives; To assess the effect of high frequency rTMS on improving spasticity in a sample of Egyptian MS patients. Patients and methods; 40 patients were recruited from the MS unit at Al-Azhar University hospitals with established diagnosis of MS and spasticity. Recruitment started from beginning of Jan, 2022 for 6 months. Patients were then randomly allocated into two groups: Study Group: 20 patients received 12 sessions of high frequency (HF) rTMS over the period of 3 weeks, followed by physical therapy (PT) for 30 minutes. rTMS protocol: Contralateral primary motor cortex (M1) was the site of stimulation. 1500 pulses (50 pulses per train with total 30 trains) per session with an intensity of 90% of the resting motor threshold at a frequency of 10 Hz were received. Each train had duration of 30 sec with inter- train delay of 25 seconds. Control Group: 20 patients received only physical therapy (PT) of 30 minutes over the period of 3 weeks). Results: The both groups received their medical treatment and physiotherapy. Compared with the control group, the study group had a statistically significant improvement. Conclusion: High frequency r-TMS could be beneficial in reducing spasticity and enhancing motor recovery in Egyptian MS patients.