Placebo-controlled study of rTMS for the treatment of Parkinson's disease

Mikhail P. Lomarev, Sulada Kanchana, William Bara-Jimenez, Meena Iyer, Eric M. Wassermann, Mark Hallett

Research output: Contribution to journalArticle

151 Citations (Scopus)

Abstract

The objective of this study is to assess the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for gait and bradykinesia in patients with Parkinson's disease (PD). In a double-blind placebo-controlled study, we evaluated the effects of 25 Hz rTMS in 18 PD patients. Eight rTMS sessions were performed over a 4-week period. Four cortical targets (left and right motor and dorsolateral prefrontal cortex) were stimulated in each session, with 300 pulses each, 100% of motor threshold intensity. Left motor cortex (MC) excitability was assessed using motor evoked potentials (MEPs) from the abductor pollicis brevis. During the 4 weeks, times for executing walking and complex hand movements tests gradually decreased. The therapeutic rTMS effect lasted for at least 1 month after treatment ended. Right-hand bradykinesia improvement correlated with increased MEP amplitude evoked by left MC rTMS after individual sessions, but improvement overall did not correlate with MC excitability. rTMS sessions appear to have a cumulative benefit for improving gait, as well as reducing upper limb bradykinesia in PD patients. Although short-term benefit may be due to MC excitability enhancement, the mechanism of cumulative benefit must have another explanation.

Original languageEnglish (US)
Pages (from-to)325-331
Number of pages7
JournalMovement Disorders
Volume21
Issue number3
DOIs
StatePublished - Mar 1 2006

Fingerprint

Transcranial Magnetic Stimulation
Parkinson Disease
Placebos
Motor Cortex
Hypokinesia
Motor Evoked Potentials
Gait
Therapeutics
Hand
Prefrontal Cortex
Upper Extremity
Walking
Safety

Keywords

  • Motor cortex
  • Parkinson's disease
  • rTMS

Cite this

Lomarev, M. P., Kanchana, S., Bara-Jimenez, W., Iyer, M., Wassermann, E. M., & Hallett, M. (2006). Placebo-controlled study of rTMS for the treatment of Parkinson's disease. Movement Disorders, 21(3), 325-331. https://doi.org/10.1002/mds.20713

Placebo-controlled study of rTMS for the treatment of Parkinson's disease. / Lomarev, Mikhail P.; Kanchana, Sulada; Bara-Jimenez, William; Iyer, Meena; Wassermann, Eric M.; Hallett, Mark.

In: Movement Disorders, Vol. 21, No. 3, 01.03.2006, p. 325-331.

Research output: Contribution to journalArticle

Lomarev, MP, Kanchana, S, Bara-Jimenez, W, Iyer, M, Wassermann, EM & Hallett, M 2006, 'Placebo-controlled study of rTMS for the treatment of Parkinson's disease', Movement Disorders, vol. 21, no. 3, pp. 325-331. https://doi.org/10.1002/mds.20713
Lomarev MP, Kanchana S, Bara-Jimenez W, Iyer M, Wassermann EM, Hallett M. Placebo-controlled study of rTMS for the treatment of Parkinson's disease. Movement Disorders. 2006 Mar 1;21(3):325-331. https://doi.org/10.1002/mds.20713
Lomarev, Mikhail P. ; Kanchana, Sulada ; Bara-Jimenez, William ; Iyer, Meena ; Wassermann, Eric M. ; Hallett, Mark. / Placebo-controlled study of rTMS for the treatment of Parkinson's disease. In: Movement Disorders. 2006 ; Vol. 21, No. 3. pp. 325-331.
@article{c98936c6586a429d9c2eb4658636c261,
title = "Placebo-controlled study of rTMS for the treatment of Parkinson's disease",
abstract = "The objective of this study is to assess the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for gait and bradykinesia in patients with Parkinson's disease (PD). In a double-blind placebo-controlled study, we evaluated the effects of 25 Hz rTMS in 18 PD patients. Eight rTMS sessions were performed over a 4-week period. Four cortical targets (left and right motor and dorsolateral prefrontal cortex) were stimulated in each session, with 300 pulses each, 100{\%} of motor threshold intensity. Left motor cortex (MC) excitability was assessed using motor evoked potentials (MEPs) from the abductor pollicis brevis. During the 4 weeks, times for executing walking and complex hand movements tests gradually decreased. The therapeutic rTMS effect lasted for at least 1 month after treatment ended. Right-hand bradykinesia improvement correlated with increased MEP amplitude evoked by left MC rTMS after individual sessions, but improvement overall did not correlate with MC excitability. rTMS sessions appear to have a cumulative benefit for improving gait, as well as reducing upper limb bradykinesia in PD patients. Although short-term benefit may be due to MC excitability enhancement, the mechanism of cumulative benefit must have another explanation.",
keywords = "Motor cortex, Parkinson's disease, rTMS",
author = "Lomarev, {Mikhail P.} and Sulada Kanchana and William Bara-Jimenez and Meena Iyer and Wassermann, {Eric M.} and Mark Hallett",
year = "2006",
month = "3",
day = "1",
doi = "10.1002/mds.20713",
language = "English (US)",
volume = "21",
pages = "325--331",
journal = "Movement Disorders",
issn = "0885-3185",
publisher = "John Wiley and Sons Inc.",
number = "3",

}

TY - JOUR

T1 - Placebo-controlled study of rTMS for the treatment of Parkinson's disease

AU - Lomarev, Mikhail P.

AU - Kanchana, Sulada

AU - Bara-Jimenez, William

AU - Iyer, Meena

AU - Wassermann, Eric M.

AU - Hallett, Mark

PY - 2006/3/1

Y1 - 2006/3/1

N2 - The objective of this study is to assess the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for gait and bradykinesia in patients with Parkinson's disease (PD). In a double-blind placebo-controlled study, we evaluated the effects of 25 Hz rTMS in 18 PD patients. Eight rTMS sessions were performed over a 4-week period. Four cortical targets (left and right motor and dorsolateral prefrontal cortex) were stimulated in each session, with 300 pulses each, 100% of motor threshold intensity. Left motor cortex (MC) excitability was assessed using motor evoked potentials (MEPs) from the abductor pollicis brevis. During the 4 weeks, times for executing walking and complex hand movements tests gradually decreased. The therapeutic rTMS effect lasted for at least 1 month after treatment ended. Right-hand bradykinesia improvement correlated with increased MEP amplitude evoked by left MC rTMS after individual sessions, but improvement overall did not correlate with MC excitability. rTMS sessions appear to have a cumulative benefit for improving gait, as well as reducing upper limb bradykinesia in PD patients. Although short-term benefit may be due to MC excitability enhancement, the mechanism of cumulative benefit must have another explanation.

AB - The objective of this study is to assess the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for gait and bradykinesia in patients with Parkinson's disease (PD). In a double-blind placebo-controlled study, we evaluated the effects of 25 Hz rTMS in 18 PD patients. Eight rTMS sessions were performed over a 4-week period. Four cortical targets (left and right motor and dorsolateral prefrontal cortex) were stimulated in each session, with 300 pulses each, 100% of motor threshold intensity. Left motor cortex (MC) excitability was assessed using motor evoked potentials (MEPs) from the abductor pollicis brevis. During the 4 weeks, times for executing walking and complex hand movements tests gradually decreased. The therapeutic rTMS effect lasted for at least 1 month after treatment ended. Right-hand bradykinesia improvement correlated with increased MEP amplitude evoked by left MC rTMS after individual sessions, but improvement overall did not correlate with MC excitability. rTMS sessions appear to have a cumulative benefit for improving gait, as well as reducing upper limb bradykinesia in PD patients. Although short-term benefit may be due to MC excitability enhancement, the mechanism of cumulative benefit must have another explanation.

KW - Motor cortex

KW - Parkinson's disease

KW - rTMS

UR - http://www.scopus.com/inward/record.url?scp=33645554798&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645554798&partnerID=8YFLogxK

U2 - 10.1002/mds.20713

DO - 10.1002/mds.20713

M3 - Article

VL - 21

SP - 325

EP - 331

JO - Movement Disorders

JF - Movement Disorders

SN - 0885-3185

IS - 3

ER -