Graduate School of Frontier Biosciences, Osaka University, 1-3 Yamadaoka, Suita, 565-0871, Japan.
Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, and Osaka University, 1-4 Yamadaoka, Suita, 565-0871, Japan.
Sci Rep. 2021 Jan 28;11(1):2472. doi: 10.1038/s41598-021-81795-3.
Parkinson's disease (PD) is a progressive neurological disorder characterised by motor and non-motor deficits. Repetitive transcranial magnetic stimulation (rTMS) over the bilateral primary motor cortex at a high frequency (5 Hz or higher) is reported to be a potential treatment of PD. We aimed to assess the effect of rTMS on eye movement control in patients with PD in their 'on' state. We enrolled 14 patients with PD and assessed motor symptoms (Movement Disorder Society-Sponsored Unified Parkinson's Disease Rating Scale; MDS-UPDRS) and eye movement performances (visually guided saccades, volitional anti-saccades, and small involuntary saccades during fixation) at baseline and after administering bilateral 10 Hz rTMS on leg region of the motor cortex. We confirmed that rTMS improved the MDS-UPDRS motor scores and found that rTMS improved the anti-saccade success rate, which requires adequate inhibition of the reflexive response. The improvement in anti-saccade success rate was correlated with that of the postural instability gait difficulty (PIGD) sub-scores of MDS-UPDRS and lower baseline Japanese version of the Montreal Cognitive Assessment scores. This result is consistent with previous findings that PIGD and inhibitory control deficits share common brain dysfunctions in PD. rTMS may alleviate dysfunctions of that circuit and have a clinical effect.
帕金森病（PD）是一种进行性的神经障碍，其特征为运动和非运动缺陷。高频（5Hz 或更高）重复经颅磁刺激（rTMS）作用于双侧初级运动皮层被报道为 PD 的一种潜在治疗方法。我们旨在评估 rTMS 对 PD 患者“开期”眼球运动控制的影响。我们纳入了 14 名 PD 患者，并在基线时和腿部运动皮层接受双侧 10Hz rTMS 治疗后评估了运动症状（运动障碍协会赞助的统一帕金森病评定量表；MDS-UPDRS）和眼球运动表现（视觉引导扫视、随意性反扫视和注视时的小自发性扫视）。我们证实 rTMS 可改善 MDS-UPDRS 运动评分，发现 rTMS 可提高反扫视成功率，这需要充分抑制反射性反应。反扫视成功率的提高与 MDS-UPDRS 的姿势不稳步态困难（PIGD）亚评分和较低的基线日本版蒙特利尔认知评估分数相关。这一结果与先前的发现一致，即 PIGD 和抑制控制缺陷在 PD 中共享共同的大脑功能障碍。rTMS 可能减轻该回路的功能障碍并具有临床效果。
