Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology University College London, London, UK.
Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Mov Disord. 2019 Jun;34(6):769-782. doi: 10.1002/mds.27705. Epub 2019 Apr 29.
Transcranial magnetic stimulation is a safe and painless non-invasive brain stimulation technique that has been largely used in the past 30 years to explore cortical function in healthy participants and, inter alia, the pathophysiology of movement disorders. During the years, its use has evolved from primarily research purposes to treatment of a large variety of neurological and psychiatric diseases. In this article, we illustrate the basic principles on which the therapeutic use of transcranial magnetic stimulation is based and review the clinical trials that have been performed in patients with movement disorders.
A search of the PubMed database for research and review articles was performed on therapeutic applications of transcranial magnetic stimulation in movement disorders. The search included the following conditions: Parkinson's disease, dystonia, Tourette syndrome and other chronic tic disorders, Huntington's disease and choreas, and essential tremor. The results of the studies and possible mechanistic explanations for the relatively minor effects of transcranial magnetic stimulation are discussed. Possible ways to improve the methodology and achieve greater therapeutic efficacy are discussed.
Despite the promising and robust rationales for the use of transcranial magnetic stimulations as a treatment tool in movement disorders, the results taken as a whole are not as successful as were initially expected. There is encouraging evidence that transcranial magnetic stimulation may improve motor symptoms and depression in Parkinson's disease, but the efficacy in other movement disorders is unclear. Possible improvements in methodology are on the horizon but have yet to be implemented in large clinical studies. © 2019 International Parkinson and Movement Disorder Society © 2019 International Parkinson and Movement Disorder Society.
经颅磁刺激是一种安全、无痛的非侵入性脑刺激技术，在过去 30 年中被广泛用于探索健康参与者的皮质功能，以及运动障碍的病理生理学等。多年来，它的用途已从主要的研究目的发展到治疗各种神经和精神疾病。在本文中，我们阐述了经颅磁刺激治疗应用的基本原理，并回顾了运动障碍患者的临床试验。
我们在 PubMed 数据库中搜索了关于经颅磁刺激治疗运动障碍的研究和综述文章。搜索条件包括：帕金森病、肌张力障碍、妥瑞氏综合征和其他慢性抽动障碍、亨廷顿病和舞蹈病以及特发性震颤。讨论了研究结果和经颅磁刺激相对较小疗效的可能机制解释。讨论了可能的方法来改进方法并实现更大的治疗效果。
尽管经颅磁刺激作为运动障碍治疗工具的使用具有有前景且合理的理论基础，但总体结果并不像最初预期的那样成功。有令人鼓舞的证据表明，经颅磁刺激可能改善帕金森病的运动症状和抑郁，但在其他运动障碍中的疗效尚不清楚。可能的方法改进正在出现，但尚未在大型临床研究中实施。国际帕金森病和运动障碍协会 2019 年©。国际帕金森病和运动障碍协会 2019 年©。
