The Effectiveness of Transcranial Brain Stimulation in Improving Clinical Signs of Hyperkinetic Movement Disorders
Identifieur interne : 000004 ( Main/Exploration ); précédent : 000003; suivant : 000005The Effectiveness of Transcranial Brain Stimulation in Improving Clinical Signs of Hyperkinetic Movement Disorders
Auteurs : Ignacio Obeso [Espagne] ; Antonio Cerasa [Italie] ; Aldo Quattrone [Italie]Source :
- Frontiers in Neuroscience [ 1662-4548 ] ; 2016.
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a safe and painless method for stimulating cortical neurons. In neurological realm, rTMS has prevalently been applied to understand pathophysiological mechanisms underlying movement disorders. However, this tool has also the potential to be translated into a clinically applicable therapeutic use. Several available studies supported this hypothesis, but differences in protocols, clinical enrollment, and variability of rTMS effects across individuals complicate better understanding of efficient clinical protocols. The aim of this present review is to discuss to what extent the evidence provided by the therapeutic use of rTMS may be generalized. In particular, we attempted to define optimal cortical regions and stimulation protocols that have been demonstrated to maximize the effectiveness seen in the actual literature for the three most prevalent hyperkinetic movement disorders: Parkinson's disease (PD) with levodopa-induced dyskinesias (LIDs), essential tremor (ET) and dystonia. A total of 28 rTMS studies met our search criteria. Despite clinical and methodological differences, overall these studies demonstrated that therapeutic applications of rTMS to “normalize” pathologically decreased or increased levels of cortical activity have given moderate progress in patient's quality of life. Moreover, the present literature suggests that altered pathophysiology in hyperkinetic movement disorders establishes motor, premotor or cerebellar structures as candidate regions to reset cortico-subcortical pathways back to normal. Although rTMS has the potential to become a powerful tool for ameliorating the clinical outcome of hyperkinetic neurological patients, until now there is not a clear consensus on optimal protocols for these motor disorders. Well-controlled multicenter randomized clinical trials with high numbers of patients are urgently required.
Url:
DOI: 10.3389/fnins.2015.00486
PubMed: 26778947
PubMed Central: 4703824
Affiliations:
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C. (CINAC), HM Hospitales – Puerta del Sur. Móstoles</institution><country>Madrid, Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea></wicri:regionArea><wicri:regionArea># see nlm:aff region in country</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Center for Networked Biomedical Research on Neurodegenerative Diseases</institution><country>Madrid, Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea></wicri:regionArea><wicri:regionArea># see nlm:aff region in country</wicri:regionArea></affiliation></author><author><name sortKey="Cerasa, Antonio" sort="Cerasa, Antonio" uniqKey="Cerasa A" first="Antonio" last="Cerasa">Antonio Cerasa</name><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology - National Research Council</institution><country>Germaneto, Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea></wicri:regionArea><wicri:regionArea># see nlm:aff region in country</wicri:regionArea></affiliation></author><author><name sortKey="Quattrone, Aldo" sort="Quattrone, Aldo" uniqKey="Quattrone A" first="Aldo" last="Quattrone">Aldo Quattrone</name><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology - National Research Council</institution><country>Germaneto, Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea></wicri:regionArea><wicri:regionArea># see nlm:aff region in country</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Neurology Unit, Institute of Neurology, University “Magna Graecia”</institution><country>Catanzaro, Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea></wicri:regionArea><wicri:regionArea># see nlm:aff region in country</wicri:regionArea></affiliation></author></analytic><series><title level="j">Frontiers in Neuroscience</title><idno type="ISSN">1662-4548</idno><idno type="e-ISSN">1662-453X</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Repetitive transcranial magnetic stimulation (rTMS) is a safe and painless method for stimulating cortical neurons. In neurological realm, rTMS has prevalently been applied to understand pathophysiological mechanisms underlying movement disorders. However, this tool has also the potential to be translated into a clinically applicable therapeutic use. Several available studies supported this hypothesis, but differences in protocols, clinical enrollment, and variability of rTMS effects across individuals complicate better understanding of efficient clinical protocols. The aim of this present review is to discuss to what extent the evidence provided by the therapeutic use of rTMS may be generalized. In particular, we attempted to define optimal cortical regions and stimulation protocols that have been demonstrated to maximize the effectiveness seen in the actual literature for the three most prevalent hyperkinetic movement disorders: Parkinson's disease (PD) with levodopa-induced dyskinesias (LIDs), essential tremor (ET) and dystonia. A total of 28 rTMS studies met our search criteria. Despite clinical and methodological differences, overall these studies demonstrated that therapeutic applications of rTMS to “normalize” pathologically decreased or increased levels of cortical activity have given moderate progress in patient's quality of life. Moreover, the present literature suggests that altered pathophysiology in hyperkinetic movement disorders establishes motor, premotor or cerebellar structures as candidate regions to reset cortico-subcortical pathways back to normal. Although rTMS has the potential to become a powerful tool for ameliorating the clinical outcome of hyperkinetic neurological patients, until now there is not a clear consensus on optimal protocols for these motor disorders. Well-controlled multicenter randomized clinical trials with high numbers of patients are urgently required.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Alexander, G E" uniqKey="Alexander G">G. E. 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Hallett</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Espagne</li><li>Italie</li></country></list><tree><country name="Espagne"><noRegion><name sortKey="Obeso, Ignacio" sort="Obeso, Ignacio" uniqKey="Obeso I" first="Ignacio" last="Obeso">Ignacio Obeso</name></noRegion><name sortKey="Obeso, Ignacio" sort="Obeso, Ignacio" uniqKey="Obeso I" first="Ignacio" last="Obeso">Ignacio Obeso</name></country><country name="Italie"><noRegion><name sortKey="Cerasa, Antonio" sort="Cerasa, Antonio" uniqKey="Cerasa A" first="Antonio" last="Cerasa">Antonio Cerasa</name></noRegion><name sortKey="Quattrone, Aldo" sort="Quattrone, Aldo" uniqKey="Quattrone A" first="Aldo" last="Quattrone">Aldo Quattrone</name><name sortKey="Quattrone, Aldo" sort="Quattrone, Aldo" uniqKey="Quattrone A" first="Aldo" last="Quattrone">Aldo Quattrone</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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