Repetitive Transcranial Magnetic Stimulation in Cervical Dystonia: Effect of Site and Repetition in a Randomized Pilot Trial
Identifieur interne : 001B50 ( Ncbi/Merge ); précédent : 001B49; suivant : 001B51Repetitive Transcranial Magnetic Stimulation in Cervical Dystonia: Effect of Site and Repetition in a Randomized Pilot Trial
Auteurs : Sarah Pirio Richardson [États-Unis] ; Sule Tinaz [États-Unis] ; Robert Chen [Canada]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
Dystonia is characterized by abnormal posturing due to sustained muscle contraction, which leads to pain and significant disability. New therapeutic targets are needed in this disorder. The objective of this randomized, sham-controlled, blinded exploratory study is to identify a specific motor system target for non-invasive neuromodulation and to evaluate this target in terms of safety and tolerability in the cervical dystonia (CD) population. Eight CD subjects were given 15-minute sessions of low-frequency (0.2 Hz) repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (MC), dorsal premotor cortex (dPM), supplementary motor area (SMA), anterior cingulate cortex (ACC) and a sham condition with each session separated by at least two days. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score was rated in a blinded fashion immediately pre- and post-intervention. Secondary outcomes included physiology and tolerability ratings. The mean change in TWSTRS severity score by site was 0.25 ± 1.7 (ACC), -2.9 ± 3.4 (dPM), -3.0 ± 4.8 (MC), -0.5 ± 1.1 (SHAM), and -1.5 ± 3.2 (SMA) with
ClinicalTrials.gov
Url:
DOI: 10.1371/journal.pone.0124937
PubMed: 25923718
PubMed Central: 4414555
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PMC:4414555Le document en format XML
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xml:lang="en" level="a" type="main">Repetitive Transcranial Magnetic Stimulation in Cervical Dystonia: Effect of Site and Repetition in a Randomized Pilot Trial</title><author><name sortKey="Pirio Richardson, Sarah" sort="Pirio Richardson, Sarah" uniqKey="Pirio Richardson S" first="Sarah" last="Pirio Richardson">Sarah Pirio Richardson</name><affiliation wicri:level="2"><nlm:aff id="aff001"><addr-line>Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico</wicri:regionArea><placeName><region type="state">Nouveau-Mexique</region></placeName></affiliation></author><author><name sortKey="Tinaz, Sule" sort="Tinaz, Sule" uniqKey="Tinaz S" first="Sule" last="Tinaz">Sule Tinaz</name><affiliation wicri:level="2"><nlm:aff id="aff002"><addr-line>Human 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type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Dystonia is characterized by abnormal posturing due to sustained muscle contraction, which leads to pain and significant disability. 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The mean change in TWSTRS severity score by site was 0.25 ± 1.7 (ACC), -2.9 ± 3.4 (dPM), -3.0 ± 4.8 (MC), -0.5 ± 1.1 (SHAM), and -1.5 ± 3.2 (SMA) with <italic>negative</italic> numbers indicating improvement in symptom control. TWSTRS scores decreased from Session 1 (15.1 ± 5.1) to Session 5 (11.0 ± 7.6). The treatment was tolerable and safe. Physiology data were acquired on 6 of 8 subjects and showed no change over time. These results suggest rTMS can modulate CD symptoms. Both dPM and MC are areas to be targeted in further rTMS studies. The improvement in TWSTRS scores over time with multiple rTMS sessions deserves further evaluation.</p><sec id="sec001"><title>Trial Registration</title><p>ClinicalTrials.gov <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT01859247">NCT01859247</ext-link></p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Batla, A" uniqKey="Batla A">A Batla</name></author><author><name sortKey="Stamelou, M" uniqKey="Stamelou M">M Stamelou</name></author><author><name sortKey="Bhatia, Kp" uniqKey="Bhatia K">KP Bhatia</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Skogseid, Im" uniqKey="Skogseid I">IM Skogseid</name></author><author><name sortKey="Roislien, J" uniqKey="Roislien J">J Roislien</name></author><author><name sortKey="Claussen, B" uniqKey="Claussen B">B Claussen</name></author><author><name sortKey="Kerty, E" uniqKey="Kerty E">E 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, CA USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25923718</article-id><article-id pub-id-type="pmc">4414555</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0124937</article-id><article-id pub-id-type="publisher-id">PONE-D-14-51936</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Repetitive Transcranial Magnetic Stimulation in Cervical Dystonia: Effect of Site and Repetition in a Randomized Pilot Trial</article-title><alt-title alt-title-type="running-head">rTMS in Cervical Dystonia</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Pirio Richardson</surname><given-names>Sarah</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref rid="cor001" ref-type="corresp">*</xref></contrib><contrib contrib-type="author"><name><surname>Tinaz</surname><given-names>Sule</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Chen</surname><given-names>Robert</given-names></name><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib></contrib-group><aff id="aff001"><label>1</label><addr-line>Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America</addr-line></aff><aff id="aff002"><label>2</label><addr-line>Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, United States of America</addr-line></aff><aff id="aff003"><label>3</label><addr-line>Toronto Western Research Institute, University of Toronto, Toronto, Canada</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Langguth</surname><given-names>Berthold</given-names></name><role>Academic Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>University of Regensburg, GERMANY</addr-line></aff><author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>We wish to confirm that co-author, Robert Chen, is a PLOS ONE Editorial Board member. This does not alter the authors' adherence to PLOS ONE Editorial policies and criteria.</p></fn><fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: SPR RC. Performed the experiments: SPR ST. Analyzed the data: SPR ST RC. Contributed reagents/materials/analysis tools: SPR RC. Wrote the paper: SPR ST RC.</p></fn><corresp id="cor001">* E-mail: <email>spiriorichardson@salud.unm.edu</email></corresp></author-notes><pub-date pub-type="epub"><day>29</day><month>4</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>10</volume><issue>4</issue><elocation-id>e0124937</elocation-id><history><date date-type="received"><day>24</day><month>11</month><year>2014</year></date><date date-type="accepted"><day>21</day><month>2</month><year>2015</year></date></history><permissions><license xlink:href="https://creativecommons.org/publicdomain/zero/1.0/"><license-p>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/publicdomain/zero/1.0/">Creative Commons CC0</ext-link> public domain dedication</license-p></license></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0124937.pdf"></self-uri><abstract><p>Dystonia is characterized by abnormal posturing due to sustained muscle contraction, which leads to pain and significant disability. New therapeutic targets are needed in this disorder. The objective of this randomized, sham-controlled, blinded exploratory study is to identify a specific motor system target for non-invasive neuromodulation and to evaluate this target in terms of safety and tolerability in the cervical dystonia (CD) population. Eight CD subjects were given 15-minute sessions of low-frequency (0.2 Hz) repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (MC), dorsal premotor cortex (dPM), supplementary motor area (SMA), anterior cingulate cortex (ACC) and a sham condition with each session separated by at least two days. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score was rated in a blinded fashion immediately pre- and post-intervention. Secondary outcomes included physiology and tolerability ratings. The mean change in TWSTRS severity score by site was 0.25 ± 1.7 (ACC), -2.9 ± 3.4 (dPM), -3.0 ± 4.8 (MC), -0.5 ± 1.1 (SHAM), and -1.5 ± 3.2 (SMA) with <italic>negative</italic> numbers indicating improvement in symptom control. TWSTRS scores decreased from Session 1 (15.1 ± 5.1) to Session 5 (11.0 ± 7.6). The treatment was tolerable and safe. Physiology data were acquired on 6 of 8 subjects and showed no change over time. These results suggest rTMS can modulate CD symptoms. Both dPM and MC are areas to be targeted in further rTMS studies. The improvement in TWSTRS scores over time with multiple rTMS sessions deserves further evaluation.</p><sec id="sec001"><title>Trial Registration</title><p>ClinicalTrials.gov <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT01859247">NCT01859247</ext-link></p></sec></abstract><funding-group><funding-statement>The research was supported by the Dystonia Coalition (Grant Number U54NS065701) which is a part of the National Institutes of Health (NIH) Rare Disease Clinical Research Network (RDCRN), supported through a collaboration between the Office of Rare Diseases Research (ORDR), National Center for Advancing Translational Sciences (NCATS), and the National Institute of Neurological Diseases and Stroke (NINDS). This research was also supported (in part or in full) by the National Center for Research Resources and National Center for Advancing Translational Science (NCATS) through Grant Number KL2TR000089 and Grant Number 8UL1TR000041. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><fig-count count="5"></fig-count><table-count count="2"></table-count><page-count count="12"></page-count></counts><custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>The de-identified database for this study are available in the LoboVault, a secure repository administered by the University of New Mexico: <ext-link ext-link-type="uri" xlink:href="http://hdl.handle.net/1928/25841">http://hdl.handle.net/1928/25841</ext-link>.</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>The de-identified database for this study are available in the LoboVault, a secure repository administered by the University of New Mexico: <ext-link ext-link-type="uri" xlink:href="http://hdl.handle.net/1928/25841">http://hdl.handle.net/1928/25841</ext-link>.</p></notes></front></pmc><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Maryland</li><li>Nouveau-Mexique</li><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="États-Unis"><region name="Nouveau-Mexique"><name sortKey="Pirio Richardson, Sarah" sort="Pirio Richardson, Sarah" uniqKey="Pirio Richardson S" first="Sarah" last="Pirio Richardson">Sarah Pirio Richardson</name></region><name sortKey="Tinaz, Sule" sort="Tinaz, Sule" uniqKey="Tinaz S" first="Sule" last="Tinaz">Sule Tinaz</name></country><country name="Canada"><region name="Ontario"><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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