Istanbul Medipol University, Turkey.
Istanbul Medipol University, Turkey.
Neurosci Lett. 2020 Apr 17;724:134837. doi: 10.1016/j.neulet.2020.134837. Epub 2020 Feb 11.
It has been already shown that the motor symptoms of the Parkinson's Disease (PD) have been improved with high frequency rTMS although there is no consensus on the most suitable target brain localization for a maximal therapeutic efficacy. Here, we aimed to compare the therapeutic effect of high frequency (5Hz) rTMS stimulation on primary motor cortex (M1) and pre-supplementary (pre SMA) regions in patients with PD who were still on pharmacological treatment. The study included right-hand dominant16 patients with PD (5 females, 11 males) with demographically and clinically similar characteristics which were randomly assigned to group 1 (n=8) and group 2 (n=8) and received left M1 and the left pre-SMA rTMS procedure, respectively. Total and sequential motor scores of the Unified Parkinson's Disease Rating Scale (UPDRSmotor) were applied to all patients at the baseline and the patients were re-evaluated under the same clinical conditions one week after the end of the sessions. Comparisons of the UPDRS-motor scores between two groups yielded significant improvements after the rTMS on pre-SMA compared to M1 (M1 p=0.14; pre-SMA p=0.01). which were especially significant for the bradykinesia (p=0.04) and axial score related items (p=0.01). This is the first study that shows the effect of rTMS on pre-SMA and it appears to be a promising option in the treatment of PD.
已经表明，帕金森病（PD）的运动症状可以通过高频 rTMS 得到改善，尽管对于最适合产生最大治疗效果的大脑目标定位还没有共识。在这里，我们旨在比较高频（5Hz）rTMS 刺激对仍在药物治疗中的 PD 患者的初级运动皮层（M1）和补充运动前区（pre-SMA）的治疗效果。该研究纳入了 16 名右利手 PD 患者（5 名女性，11 名男性），具有相似的人口统计学和临床特征，他们被随机分配到第 1 组（n=8）和第 2 组（n=8），分别接受左侧 M1 和左侧 pre-SMA rTMS 程序。所有患者在基线时应用统一帕金森病评定量表（UPDRSmotor）的总分和序贯运动评分，在疗程结束后一周在相同的临床条件下对患者进行重新评估。与 M1 相比，pre-SMA 上 rTMS 后两组的 UPDRS-motor 评分比较显示出显著改善（M1 p=0.14；pre-SMA p=0.01）。这对于运动迟缓（p=0.04）和轴性评分相关项目（p=0.01）尤其显著。这是第一项研究表明 rTMS 对 pre-SMA 的影响，它似乎是 PD 治疗的一种有前途的选择。
