Khedr Eman M, Rothwell John C, Shawky Ola A, Ahmed Mohammed A, Foly Nageh, Hamdy Ahmed
Department of Neurology, Assiut University Hospital, Assiut, Egypt.
Mov Disord. 2007 May 15;22(7):1046-50. doi: 10.1002/mds.21460.
Repeated session of repetitive transcranial magnetic stimulation (rTMS) over motor cortex have been reported to produce significant improvement of motor performance in patients with parkinson's disease (PD). In addition, it is known that a single session of rTMS over motor cortex transiently increases DA in striatum. Here, we test whether repeated sessions of rTMS increase serum dopamine in PD patients and whether this correlates with changes in clinical rating scales.
Twenty untreated PD patients with moderate to severe symptoms (Hoehn & Yahr state III-V 1967) were assessed on the Unified Parkinson's Disease Rating Scale (UPDRS), and with an enzyme immunoassay for quantitative determination of plasma dopamine before and after six daily sessions of 25 Hz rTMS with 3,000 stimuli over the right and left hand and leg motor cortex.
There was significant improvement in UPDRS compared with the baseline. Serum dopamine level also was significantly elevated over the same interval. There was a significant correlation between UPDRS and serum dopamine level before and after treatment.
Improved motor performance in PD after repeated session of rTMS may be related to an elevation of serum dopamine concentration.
据报道，对帕金森病（PD）患者的运动皮层进行重复的重复经颅磁刺激（rTMS）可显著改善其运动表现。此外，已知对运动皮层进行单次rTMS可使纹状体中的多巴胺短暂增加。在此，我们测试重复进行rTMS是否会增加PD患者的血清多巴胺水平，以及这是否与临床评分量表的变化相关。
对20例未经治疗的中度至重度症状的PD患者（Hoehn & Yahr分级为III - V级，1967年标准）进行统一帕金森病评定量表（UPDRS）评估，并采用酶免疫分析法在对右手、左手和腿部运动皮层进行每日6次、每次25 Hz、3000次刺激的rTMS前后定量测定血浆多巴胺。
与基线相比，UPDRS有显著改善。血清多巴胺水平在同一时间段内也显著升高。治疗前后UPDRS与血清多巴胺水平之间存在显著相关性。
重复进行rTMS后PD患者运动表现的改善可能与血清多巴胺浓度升高有关。
