Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is widely used for the treatment of Parkinson’s Disease (PD). Novel insights into the mechanisms underlying the efficacy of DBS suggest that stimulation of projection tracts to the STN arising from premotor and motor areas may be responsible for treatment effects reducing pathological oscillatory activity within the STN. Several studies have demonstrated the efficacy of transcranial magnetic stimulation (TMS) for the treatment of PD. Our hypotheses were, that both DBS and TMS effects may share similarities and that TMS effects may arise due to propagation of pulses via cortico-subthalamic projections. As there is evidence suggesting that multifocal DBS of the STN may be more efficient than single site stimulation, applying a TMS protocol which includes stimulation of more than one motor areas in a temporally coordinated manner may allow for better treatment results than single site TMS. A novel double-pulse TMS protocol using custom-build coils (manufacturer MagVenture) applied to premotor and motor areas was used to treat motor symptoms in PD patients (H&Y stage ⩽ 3). Double-pulse TMS was applied at 1 Hz with 25 ms interstimulus interval to the primary motor cortex (M1) and either the supplementary motor area (SMA, anterior of leg M1) or the dorsal premotor cortex (PMd, 5 cm anterior of hand M1) of the side more affected by motor symptoms. Stimulation intensity was 95% RMT. 40 block of TMS were applied with 25 double pulses per block. MDS-UPDRS-III was filmed prior, immediately after and following one hour after stimulation and analysed offline by two certified raters (C.F., T.W.) which were blinded to condition and time of recording in a random order. We additionally recorded the tapping performance (taps with index finger over 30 s at maximum velocity). The experiment was controlled by a sham condition (TMS intensity was reduced to 20% RMT). 10 PD patients participated in the study (3 f., 7 m., age 59, 6 ± 10, 2 years). There was no significant change in MDS-UPDRS-III following double pulse TMS to SMA/M1 or PMd/M1 compared to sham (rmANOVA, main effect for CONDITION, F(2,12) = 2.352, p = 0.137, main effect for TIME (pre, post-0 h, post-1 h), F(2,12) = 1.918, p = 0.189, interaction CONDITION ∗ TIME, F(4,24) = 0.931, p = 0.463). Also there was no change in tapping speed (rmANOVA, main effect for CONDITION, F(2,12) = 0.995, p = 0.398, main effect for TIME (pre, post-0 h, post-1 h), F(2,12) = 0.062, p = 0.941, interaction CONDITION ∗ TIME, F(4,24) = 0.607, p = 0.661) or other parameters analysed. So far we could not achieve improvements of motor symptoms in PD patients using our double-pulse TMS paradigm. This may result from insufficiently characterized or infeasible stimulation sites (SMA and PMd). Thus, we employed a study to further characterize the site and effects of PMd stimulation. On the other hand, due to technical issues SMA stimulation appeared not to be generally feasible (e.g. the deep localization of SMA in the interhemispheric sulcus). Supported by Hertie-Stiftung “Cortexplorer” (AZ.: P1140048)