Ghabra M B, Hallett M, Wassermann E M
Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Neurology. 1999 Mar 10;52(4):768-70. doi: 10.1212/wnl.52.4.768.
To reevaluate the effect of subthreshold repetitive transcranial magnetic stimulation (rTMS) on concurrent fine movement in PD.
A previous study showed a beneficial effect of rTMS on the performance of six patients with PD on the Grooved Pegboard test.
The authors repeated this experiment in 11 patients with idiopathic PD who performed the test while the stimulating coil discharged continuously at 5 Hz, either over the contralateral motor cortex at just below the threshold for movement, or in the air near the head as a control. Patients were tested twice under both conditions.
Although some patients performed faster with rTMS, others showed the opposite effect. There was no significant effect of rTMS in the group, nor did baseline performance or the order of conditions interact with the effect of rTMS.
Based on this larger and more comprehensive study, simultaneous, 5-Hz subthreshold rTMS over the motor cortex does not have consistent or potentially therapeutic effects on movement in PD.
重新评估阈下重复经颅磁刺激（rTMS）对帕金森病（PD）患者同时进行精细运动的影响。
先前一项研究表明，rTMS对6例PD患者在凹槽插板试验中的表现有有益影响。
作者对11例特发性PD患者重复了该实验，这些患者在刺激线圈以5Hz持续放电的同时进行测试，刺激部位要么是对侧运动皮层，强度略低于运动阈值，要么是头部附近空气中作为对照。患者在两种条件下均接受两次测试。
尽管一些患者在rTMS刺激下表现得更快，但另一些患者则表现出相反的效果。rTMS对该组患者没有显著影响，基线表现或测试条件顺序也与rTMS的效果没有相互作用。
基于这项规模更大、更全面的研究，运动皮层上同时进行的5Hz阈下rTMS对PD患者的运动没有一致的或潜在的治疗效果。
