Medrano-Hernández Alma, Neri-Nani Gabriel, Rodríguez-Violante Mayela, Drucker-Colín René, Chavarría Anahí
Unidad de Medicina Experimental "Ruy Pérez Tamayo", Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City CP 06726, Mexico.
Programa de Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México, Mexico City CP 04510, Mexico.
Biomedicines. 2025 Jul 8;13(7):1663. doi: 10.3390/biomedicines13071663.
Parkinson's disease (PD) presents a significant challenge due to its wide range of motor, non-motor, and treatment-related symptoms. Non-invasive interventions like transcranial magnetic stimulation (TMS) are being explored for potential therapeutic benefits. This study aimed to assess if a high-frequency repetitive TMS protocol (HF-rTMS) consisting of 10 trains of 100 pulses of rTMS at 25 Hz over the motor cortex (M1) at 80% of the resting motor threshold could be effective in treating motor or non-motor symptoms in patients with PD with levodopa-induced dyskinesias. A randomized, single-blinded, placebo-controlled pilot trial was conducted with eleven PD patients. Nine patients received HF-rTMS, while two received sham stimulation. Patients were exhaustively evaluated using validated clinical scales to assess motor and non-motor symptoms. The study followed a rigorous protocol to avoid bias, with assessments conducted by a neurologist specialized in single-blinded movement disorder. The HF-rTMS group experienced a statistically significant slight worsening in both motor and non-motor symptoms, particularly in the mood/cognition and gastrointestinal domains. However, positive effects were observed in some non-motor symptoms, specifically reduced excessive sweating and weight. No adverse effects were reported. : Although HF-rTMS did not produce significant motor improvements, its potential benefit on specific non-motor symptoms, such as autonomic regulation, warrants further investigation.
帕金森病(PD)因其广泛的运动、非运动及治疗相关症状而构成重大挑战。经颅磁刺激(TMS)等非侵入性干预措施正在被探索其潜在治疗益处。本研究旨在评估一种高频重复经颅磁刺激方案(HF-rTMS),即在运动皮层(M1)以静息运动阈值的80%给予25赫兹的10组每组100个脉冲的重复经颅磁刺激,是否能有效治疗伴有左旋多巴诱导的异动症的帕金森病患者的运动或非运动症状。对11名帕金森病患者进行了一项随机、单盲、安慰剂对照的试点试验。9名患者接受HF-rTMS,2名接受假刺激。使用经过验证的临床量表对患者进行全面评估,以评估运动和非运动症状。该研究遵循严格方案以避免偏差,由一位专门从事单盲运动障碍研究的神经科医生进行评估。HF-rTMS组在运动和非运动症状方面均出现了具有统计学意义的轻微恶化,尤其是在情绪/认知和胃肠道领域。然而,在一些非运动症状方面观察到了积极效果,特别是多汗和体重减轻。未报告不良反应。虽然HF-rTMS未产生显著的运动改善,但其对特定非运动症状(如自主神经调节)的潜在益处值得进一步研究。