P 50 The safety and feasibility of deep transcranial magnetic stimulation in patients with Parkinson syndromes and medical refractory symptoms: a retrospective analysis

Abstract

Introduction: Deep transcranial magnetic stimulation (dTMS) is a relatively novel, non-invasive therapeutic tool whereby magnetic fields are utilized to assert neuromodulatory effects in targeted brain area. The aim of the current study was to investigate the safety and feasibility of dTMS as an add-on treatment for patients with Parkinson syndromes in a retrospective manner. Hypotheses included if the application is safe and not associated with severe adverse reactions; if dTMS can successfully be applied to patients regardless of their diagnosis, age, impairment profile and symptom severity; and to assess the potential short- term effects of this application on patients‘ self- related symptom severity as well as on motor and cognitive and emotional functions. Patients and Methods: Multifaceted patient data of patients with different parkinson syndroms (PD, atypical) (N = 21) were analyzed to examine adverse effects (AEs) as well as short-term effects of the dTMS treatment on patients‘ self-rated symptom severity and on motor, cognitive, and emotional functions obtained in neuropsychological tests and questionnaires. Results: We found dTMS to be safe and generally well tolerated with headache as the most common AE. A large variation was apparent in the rate (50%) and severity ratings ( M = 5.4, SD = 2.6) of the reported AEs, which was not related to the examined patient characteristics nor stimulation parameters. The explorative analysis of the short-term effects revealed a significant decrease in the self-rated main motor symptom severity that were recorded at each stimulation session ( t (18) = -2.06, p = .027), which was more pronounced in PD patients. There were no correlations between the changes in main symptom severity and different stimulation parameters in our sample. Interestingly, older patients reported larger decreases in symptom severity. No significant effect of dTMS could be found on cognition. Depression scores improved, but failed significance. Conclusion: DTMS can be safely administered to patients with Parkinson syndromes with medical refractory symptoms. Moreover, treatment with dTMS can lead to a subjective decrease in the self-rated main symptom severity especially in PD patients.