Repetitive Transcranial Magnetic Stimulation Improves Handwriting in Parkinson's Disease
Identifieur interne : 000387 ( Pmc/Curation ); précédent : 000386; suivant : 000388Repetitive Transcranial Magnetic Stimulation Improves Handwriting in Parkinson's Disease
Auteurs : Bubblepreet K. Randhawa [Canada] ; Becky G. Farley [États-Unis] ; Lara A. Boyd [Canada]Source :
- Parkinson's Disease [ 2090-8083 ] ; 2013.
Abstract
Url:
DOI: 10.1155/2013/751925
PubMed: 23841021
PubMed Central: 3681307
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Repetitive Transcranial Magnetic Stimulation Improves Handwriting in Parkinson's Disease</title><author><name sortKey="Randhawa, Bubblepreet K" sort="Randhawa, Bubblepreet K" uniqKey="Randhawa B" first="Bubblepreet K." last="Randhawa">Bubblepreet K. Randhawa</name><affiliation wicri:level="1"><nlm:aff id="I1">Graduate Program in Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3</nlm:aff><country>Canada</country><wicri:regionArea>Graduate Program in Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC</wicri:regionArea></affiliation></author><author><name sortKey="Farley, Becky G" sort="Farley, Becky G" uniqKey="Farley B" first="Becky G." last="Farley">Becky G. Farley</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Physiology, University of Arizona, McKale Center 229C, P.O. Box 210096, Tucson, AZ 85721, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Physiology, University of Arizona, McKale Center 229C, P.O. Box 210096, Tucson, AZ 85721</wicri:regionArea></affiliation></author><author><name sortKey="Boyd, Lara A" sort="Boyd, Lara A" uniqKey="Boyd L" first="Lara A." last="Boyd">Lara A. Boyd</name><affiliation wicri:level="1"><nlm:aff id="I1">Graduate Program in Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3</nlm:aff><country>Canada</country><wicri:regionArea>Graduate Program in Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3</nlm:aff><country>Canada</country><wicri:regionArea>Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23841021</idno><idno type="pmc">3681307</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681307</idno><idno type="RBID">PMC:3681307</idno><idno type="doi">10.1155/2013/751925</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">000387</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000387</idno><idno type="wicri:Area/Pmc/Curation">000387</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000387</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Repetitive Transcranial Magnetic Stimulation Improves Handwriting in Parkinson's Disease</title><author><name sortKey="Randhawa, Bubblepreet K" sort="Randhawa, Bubblepreet K" uniqKey="Randhawa B" first="Bubblepreet K." last="Randhawa">Bubblepreet K. Randhawa</name><affiliation wicri:level="1"><nlm:aff id="I1">Graduate Program in Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3</nlm:aff><country>Canada</country><wicri:regionArea>Graduate Program in Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC</wicri:regionArea></affiliation></author><author><name sortKey="Farley, Becky G" sort="Farley, Becky G" uniqKey="Farley B" first="Becky G." last="Farley">Becky G. Farley</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Physiology, University of Arizona, McKale Center 229C, P.O. Box 210096, Tucson, AZ 85721, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Physiology, University of Arizona, McKale Center 229C, P.O. Box 210096, Tucson, AZ 85721</wicri:regionArea></affiliation></author><author><name sortKey="Boyd, Lara A" sort="Boyd, Lara A" uniqKey="Boyd L" first="Lara A." last="Boyd">Lara A. Boyd</name><affiliation wicri:level="1"><nlm:aff id="I1">Graduate Program in Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3</nlm:aff><country>Canada</country><wicri:regionArea>Graduate Program in Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3</nlm:aff><country>Canada</country><wicri:regionArea>Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC</wicri:regionArea></affiliation></author></analytic><series><title level="j">Parkinson's Disease</title><idno type="ISSN">2090-8083</idno><idno type="eISSN">2042-0080</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><italic>Background</italic>. Parkinson disease (PD) is characterized by hypometric movements resulting from loss of dopaminergic neurons in the substantia nigra. PD leads to decreased activation of the supplementary motor area (SMA); the net result of these changes is a poverty of movement. The present study determined the impact of 5 Hz repetitive transcranial magnetic stimulation (rTMS) over the SMA on a fine motor movement, handwriting (writing cursive “l”s), and on cortical excitability, in individuals with PD. <italic>Methods</italic>. In a cross-over design, ten individuals with PD were randomized to receive either 5 Hz or control stimulation over the SMA. Immediately following brain stimulation right handed writing was assessed. <italic>Results</italic>. 5 Hz stimulation increased vertical size of handwriting and diminished axial pressure. In addition, 5 Hz rTMS significantly decreased the threshold for excitability in the primary motor cortex. <italic>Conclusions</italic>. These data suggest that in the short term 5 Hz rTMS benefits functional fine motor task performance, perhaps by altering cortical excitability across a network of brain regions. Further, these data may provide the foundation for a larger investigation of the effects of noninvasive brain stimulation over the SMA in individuals with PD.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Teulings, Hl" uniqKey="Teulings H">HL Teulings</name></author><author><name sortKey="Stelmach, Ge" uniqKey="Stelmach G">GE Stelmach</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Flash, T" uniqKey="Flash T">T Flash</name></author><author><name sortKey="Henis, E" uniqKey="Henis E">E Henis</name></author><author><name sortKey="Inzelberg, R" uniqKey="Inzelberg R">R Inzelberg</name></author><author><name sortKey="Korczyn, Ad" uniqKey="Korczyn A">AD Korczyn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Longstaff, Mg" uniqKey="Longstaff M">MG Longstaff</name></author><author><name sortKey="Mahant, Pr" uniqKey="Mahant P">PR Mahant</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Parkinsons Dis</journal-id><journal-id journal-id-type="iso-abbrev">Parkinsons Dis</journal-id><journal-id journal-id-type="publisher-id">PD</journal-id><journal-title-group><journal-title>Parkinson's Disease</journal-title></journal-title-group><issn pub-type="ppub">2090-8083</issn><issn pub-type="epub">2042-0080</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23841021</article-id><article-id pub-id-type="pmc">3681307</article-id><article-id pub-id-type="doi">10.1155/2013/751925</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>Repetitive Transcranial Magnetic Stimulation Improves Handwriting in Parkinson's Disease</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Randhawa</surname><given-names>Bubblepreet K.</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Farley</surname><given-names>Becky G.</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Boyd</surname><given-names>Lara A.</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I3"><sup>3</sup></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Graduate Program in Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3</aff><aff id="I2"><sup>2</sup>Department of Physiology, University of Arizona, McKale Center 229C, P.O. Box 210096, Tucson, AZ 85721, USA</aff><aff id="I3"><sup>3</sup>Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3</aff><author-notes><corresp id="cor1">*Lara A. Boyd: <email>boyd.lab@ubc.ca</email></corresp><fn fn-type="other"><p>Academic Editor: Gammon M. Earhart</p></fn></author-notes><pub-date pub-type="ppub"><year>2013</year></pub-date><pub-date pub-type="epub"><day>8</day><month>5</month><year>2013</year></pub-date><volume>2013</volume><elocation-id>751925</elocation-id><history><date date-type="received"><day>15</day><month>2</month><year>2013</year></date><date date-type="accepted"><day>25</day><month>3</month><year>2013</year></date></history><permissions><copyright-statement>Copyright © 2013 Bubblepreet K. Randhawa et al.</copyright-statement><copyright-year>2013</copyright-year><license license-type="open-access"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p><italic>Background</italic>. Parkinson disease (PD) is characterized by hypometric movements resulting from loss of dopaminergic neurons in the substantia nigra. PD leads to decreased activation of the supplementary motor area (SMA); the net result of these changes is a poverty of movement. The present study determined the impact of 5 Hz repetitive transcranial magnetic stimulation (rTMS) over the SMA on a fine motor movement, handwriting (writing cursive “l”s), and on cortical excitability, in individuals with PD. <italic>Methods</italic>. In a cross-over design, ten individuals with PD were randomized to receive either 5 Hz or control stimulation over the SMA. Immediately following brain stimulation right handed writing was assessed. <italic>Results</italic>. 5 Hz stimulation increased vertical size of handwriting and diminished axial pressure. In addition, 5 Hz rTMS significantly decreased the threshold for excitability in the primary motor cortex. <italic>Conclusions</italic>. These data suggest that in the short term 5 Hz rTMS benefits functional fine motor task performance, perhaps by altering cortical excitability across a network of brain regions. Further, these data may provide the foundation for a larger investigation of the effects of noninvasive brain stimulation over the SMA in individuals with PD.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Stereotaxic system for coil placement. Brainsight was used to locate left SMA (as per Talairach coordinates) and left M1; markers were placed to ensure accuracy of coil placement within and across stimulation sessions.</p></caption><graphic xlink:href="PD2013-751925.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Example of raw data from handwriting task from an individual trial showing a rectangular box of 0.79 by 8 inches; participants were instructed to match the height of their loops to the size of the box.</p></caption><graphic xlink:href="PD2013-751925.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Significant interactions in behavioural data from handwriting task for (a) vertical size, (b) upstroke size, and (c) average pen pressure. Error bars are standard error of the mean (SEM).</p></caption><graphic xlink:href="PD2013-751925.003"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Participant Characteristics.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">P</th><th align="center" rowspan="1" colspan="1">Sex</th><th align="center" rowspan="1" colspan="1">Age </th><th align="center" rowspan="1" colspan="1">MoCA</th><th align="center" rowspan="1" colspan="1">UPDRS-III</th><th align="center" rowspan="1" colspan="1">H&Y</th><th align="center" rowspan="1" colspan="1">DH</th><th align="center" rowspan="1" colspan="1">More affected side </th><th align="center" rowspan="1" colspan="1">Disease duration (years)</th><th align="left" rowspan="1" colspan="1">Medication (daily dose—mg)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">52</td><td align="center" rowspan="1" colspan="1">25</td><td align="center" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">1.5</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">4</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa 100/25 QID <break></break>Entacapone 200 QID <break></break>Pramipexole 1 QID </td></tr><tr><td align="left" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">73</td><td align="center" rowspan="1" colspan="1">28</td><td align="center" rowspan="1" colspan="1">18</td><td align="center" rowspan="1" colspan="1">1.5</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">10</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa CR 200/50 QID <break></break>Levodopa/Carbidopa/Entacapone 100/25/200 QID <break></break>Levodopa/Carbidopa 120/25 TID </td></tr><tr><td align="left" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">77</td><td align="center" rowspan="1" colspan="1">27</td><td align="center" rowspan="1" colspan="1">11</td><td align="center" rowspan="1" colspan="1">1.5</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">4</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa 250 QD <break></break></td></tr><tr><td align="left" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">77</td><td align="center" rowspan="1" colspan="1">24</td><td align="center" rowspan="1" colspan="1">13</td><td align="center" rowspan="1" colspan="1">1.5</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">4</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa CR 100/25 QID <break></break>Levodopa/Carbidopa 100/25 BID </td></tr><tr><td align="left" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">71</td><td align="center" rowspan="1" colspan="1">29</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">8</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa CR 200-50 TID <break></break>Rasagiline 1 QD </td></tr><tr><td align="left" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">77</td><td align="center" rowspan="1" colspan="1">29</td><td align="center" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">1.5</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">L (more axial)</td><td align="center" rowspan="1" colspan="1">3</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa CR 100/25 QID</td></tr><tr><td align="left" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">72</td><td align="center" rowspan="1" colspan="1">26</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">1.5</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">R (more axial)</td><td align="center" rowspan="1" colspan="1">5</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa 200/50 q5H <break></break>Pramipexole 1 TID </td></tr><tr><td align="left" rowspan="1" colspan="1">8</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">64</td><td align="center" rowspan="1" colspan="1">28</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">1.5</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">R (more axial)</td><td align="center" rowspan="1" colspan="1">6</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa CR 100/25 q5H <break></break>Pramipexole 1 TID <break></break>Rasagiline 0.5 QD </td></tr><tr><td align="left" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">64</td><td align="center" rowspan="1" colspan="1">30</td><td align="center" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">1.5</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">4</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa 100/25 QID <break></break>Pramipexole 0.5 QID </td></tr><tr><td align="left" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">78</td><td align="center" rowspan="1" colspan="1">29</td><td align="center" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">1.5</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">3</td><td align="left" rowspan="1" colspan="1">Levodopa/Carbidopa CR 200/50 QID </td></tr></tbody></table><table-wrap-foot><fn><p>P: participant, Age: years, F: female, M: male, R: right; L: Left, MoCA: Montreal Cognitive Assessment, UPDRS-III: Unified Parkinson's Disease Rating Scale-motor section, H&Y: Hoehn and Yahr's stages, DH: dominant hand, CR: controlled release, QD: one/day, BID: two times/day, TID: three/day, QID: Four/day, q5H: Five/day.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Average means (SD) before and after rTMS for each group and <italic>P</italic> values for all segments, upstrokes and downstrokes.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2" colspan="1">Variable</th><th align="center" colspan="3" rowspan="1">All segments</th><th align="center" colspan="3" rowspan="1">Upstroke</th><th align="center" colspan="3" rowspan="1">Downstroke</th></tr><tr><th align="center" rowspan="1" colspan="1">5 Hz</th><th align="center" rowspan="1" colspan="1">Control</th><th align="center" rowspan="1" colspan="1"><italic>P</italic> value</th><th align="center" rowspan="1" colspan="1">5 Hz</th><th align="center" rowspan="1" colspan="1">Control</th><th align="center" rowspan="1" colspan="1"><italic>P</italic> value</th><th align="center" rowspan="1" colspan="1">5 Hz</th><th align="center" rowspan="1" colspan="1">Control</th><th align="center" rowspan="1" colspan="1"><italic>P</italic> value</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Vertical size (cm)</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Before</td><td align="center" rowspan="1" colspan="1">1.87 (0.09)</td><td align="center" rowspan="1" colspan="1">1.85 (0.12)</td><td align="center" rowspan="2" colspan="1">0.04<sup>∗2</sup></td><td align="center" rowspan="1" colspan="1">1.88 (0.09)</td><td align="center" rowspan="1" colspan="1">1.87 (0.12)</td><td align="center" rowspan="2" colspan="1">0.01<sup>∗2</sup></td><td align="center" rowspan="1" colspan="1">1.86 (0.09)</td><td align="center" rowspan="1" colspan="1">1.84 (0.12)</td><td align="center" rowspan="2" colspan="1">NS</td></tr><tr><td align="left" rowspan="1" colspan="1"> After</td><td align="center" rowspan="1" colspan="1">1.92 (0.10)</td><td align="center" rowspan="1" colspan="1">1.84 (0.16)</td><td align="center" rowspan="1" colspan="1">1.94 (0.09)</td><td align="center" rowspan="1" colspan="1">1.85 (0.17)</td><td align="center" rowspan="1" colspan="1">1.90 (0.12)</td><td align="center" rowspan="1" colspan="1">1.84 (0.16)</td></tr><tr><td align="left" rowspan="1" colspan="1">Peak Vertical velocity (cm/sec)</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Before</td><td align="center" rowspan="1" colspan="1">6.97 (1.72)</td><td align="center" rowspan="1" colspan="1">7.54 (1.08)</td><td align="center" rowspan="2" colspan="1">0.01<sup>∗1</sup></td><td align="center" rowspan="1" colspan="1">7.41 (1.48)</td><td align="center" rowspan="1" colspan="1">8.11 (1.31)</td><td align="center" rowspan="2" colspan="1">NS</td><td align="center" rowspan="1" colspan="1">6.55 (2.07)</td><td align="center" rowspan="1" colspan="1">7.06 (1.38)</td><td align="center" rowspan="2" colspan="1">0.02<sup>∗1</sup></td></tr><tr><td align="left" rowspan="1" colspan="1"> After</td><td align="center" rowspan="1" colspan="1">7.99 (1.90)</td><td align="center" rowspan="1" colspan="1">7.98 (1.62)</td><td align="center" rowspan="1" colspan="1">8.34 (1.89)</td><td align="center" rowspan="1" colspan="1">8.48 (1.62)</td><td align="center" rowspan="1" colspan="1">7.72 (2.06)</td><td align="center" rowspan="1" colspan="1">7.59 (1.86)</td></tr><tr><td align="left" rowspan="1" colspan="1">Average pen Beforessure</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Before</td><td align="center" rowspan="1" colspan="1">658.94 (209.10)</td><td align="center" rowspan="1" colspan="1">546.43 (204.47)</td><td align="center" rowspan="2" colspan="1">NS</td><td align="center" rowspan="1" colspan="1">675.30 (211.95)</td><td align="center" rowspan="1" colspan="1">566.43 (195.68)</td><td align="center" rowspan="2" colspan="1">0.05<sup>∗2</sup></td><td align="center" rowspan="1" colspan="1">642.39 (211.93)</td><td align="center" rowspan="1" colspan="1">536.50 (207.25)</td><td align="center" rowspan="2" colspan="1">NS</td></tr><tr><td align="left" rowspan="1" colspan="1"> After</td><td align="center" rowspan="1" colspan="1">564.64 (154.47)</td><td align="center" rowspan="1" colspan="1">550.07 (254.76)</td><td align="center" rowspan="1" colspan="1">581.09 (161.34)</td><td align="center" rowspan="1" colspan="1">570.02 (254.05)</td><td align="center" rowspan="1" colspan="1">543.31 (150.10)</td><td align="center" rowspan="1" colspan="1">528.36 (259.84)</td></tr></tbody></table><table-wrap-foot><fn><p>NS: not significant; <sup>∗1</sup>significant main effect of time; <sup>∗2</sup>significant session by time interaction.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label><caption><p>Average means (SD) before and after rTMS for each group, and <italic>P</italic> values for RMT.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2" colspan="1">Variable</th><th align="center" colspan="2" rowspan="1">TMS</th><th align="center" rowspan="2" colspan="1"><italic>P</italic> value</th></tr><tr><th align="center" rowspan="1" colspan="1">Active</th><th align="center" rowspan="1" colspan="1">Sham</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">RMT</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">Before</td><td align="center" rowspan="1" colspan="1">63.1 (10.55)</td><td align="center" rowspan="1" colspan="1">62.3 (8.08)</td><td align="center" rowspan="2" colspan="1">0.05*</td></tr><tr><td align="left" rowspan="1" colspan="1">After</td><td align="center" rowspan="1" colspan="1">60.2 (9.14)</td><td align="center" rowspan="1" colspan="1">61.2 (8.59)</td></tr></tbody></table><table-wrap-foot><fn><p> *Significant SESSION by TIME interaction.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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