Abstract
To evaluate the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) for depressed Parkinson's disease (PD) patients, we examined a series of clinical test batteries and analyzed the EEG data with Low Resolution Electromagnetic Tomography (LORETA). We studied seven depressed PD patients. The severity of all PD patients assessed by the Hoehn and Yahr stage was higher than stage 2. The patients underwent 0.2 Hz rTMS to the frontal areas using a large circular coil for 20 times per day at an intensity of 1.5 T. Sessions were performed for 5 successive days. The motor activity with finger tapping and 20-m walking, Unified Parkinson's Disease Rating Scale, and actigraphy were used to assess changes in the clinical performance before and after rTMS. Furthermore, we recorded 20-channel spontaneous eyes-closed resting EEGs. Each 2-s artifact-free epoch was digitally filtered into seven frequency bands. LORETA was used to compute the three-dimensional intracerebral distribution of electric activity of each of the EEG frequency bands. Images of before and after rTMS were statistically compared using non-parametric randomization tests with corrections for multiple testing. The subjects showed improvements of motor activity and relief of depression after TMS. LORETA showed stronger activation in the theta band in the right superior temporal gyrus, and decreased activation in the alpha1 and beta1 bands in the frontal gyrus. These results suggest that low-frequency rTMS may be a valuable technique in the adjunct treatment of depressed PD patients, possibly by inducing changes of the cortical inhibitory system.
Published Version
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