The effect of low frequency repetitive transcranial magnetic stimulation on Parkinson's plus syndrome

Abstract

Objective To study the effects of repeated transcranial magnetic stimulation(rTMS)on Parkinson's plus syndrome(PPS).Methods Fifteen in-patients with PPS were studied between 2005 and 2008.The patients received 1 Hz rTMS at an intensity 30%over the threshold.The rTMS was applied on the hand representive area of the bilateral first motor cortex,50 stimulations on each side,5 arrays,for 5 min,once daily for 15 d.Hamilton's depression scale(HAMD),Hamilton's anxiety scale(HAMA),the unified Parkinson's disease rating scale(UPDRS,which can be subdivided into UPDRS Ⅰ,UPDRS Ⅱ and UPDRS Ⅲ),an activities of daily living scale(ADL),the mini-mental state examination(MMSE)and motor evoked potential(MEP)were assessed before and immediately after 15 d of rTMS treatment. Results Average HAMD,HAMA,UPDRS,UPDRS Ⅱ and UPDRS Ⅲ scores all decreased,and ADL scores increased significantly after treatment,while UPDRSⅠand MMSE scores were unchanged before and after treatment.No significant changes in resting motor threshold or central motor conduction time of the MEP were observed after rTMS treatment. Conclusion Clinical symptoms of PPS patients improved after rTMS treatment and side effects were few.Depression,anxiety,motor function and ability in the activities of daily living improved greatly.Repeated transcranial magnetic stimulation is a potential treatment for PPS patients.There may be no correlation between the effective mechanism of rTMS and cortex excitation. Key words: Repeated transcranial magnetic stimulation; Parkinson's plus syndrome; Therapeuticeffects; Motor evoked potential