Transcranial magnetic stimulation in treatment of motor and nonmotor symptoms of Parkinson’s disease

Abstract

This review highlights topical issues of the use of transcranial magnetic stimulation as a non‑drug method for treating motor and non‑motor symptoms of Parkinson’s disease. The method of transcranial magnetic stimulation has a wide therapeutic potential since it has the ability to induce neuronal plasticity by modulating neuronal connections in the human brain, and in particular in patients with Parkinson’s disease. Several areas of application of transcranial magnetic stimulation in patients with Parkinson’s disease are currently being considered. Its effect on the severity of motor symptoms, such as tremor, rigidity, bradykinesia and gait disturbances, the manifestation of non‑motor symptoms, such as cognitive impairment and depressive disorders, is described. It is proved that patients with Parkinson’s disease have a wide range of disorders of neurophysiological parameters in the primary motor cortex, which are positively correlated with the severity of clinical symptoms of Parkinson’s disease and can be used for objectification of transcranial magnetic stimulation treatment results. According to the analysis of literature data, transcranial magnetic stimulation significantly improves the function of the upper extremities, the ability to walk and score III of UPDRS not only in the short term but also in the long term in patients with Parkinson’s disease. Today, a topical issue is the discussion of possible mechanisms of therapeutic action of transcranial magnetic stimulation on the level of cytokines associated with neuroinflammation in patients with Parkinson’s disease. The results of studies on the treatment of Parkinson’s disease by the method of transcranial magnetic stimulation are promising and encouraging, but many questions and controversies remain, which require additional study.