Controlled trial on the effect of 10 days low‐frequency repetitive transcranial magnetic stimulation (rTMS) on motor signs in Parkinson's disease
Identifieur interne : 001D70 ( Main/Curation ); précédent : 001D69; suivant : 001D71Controlled trial on the effect of 10 days low‐frequency repetitive transcranial magnetic stimulation (rTMS) on motor signs in Parkinson's disease
Auteurs : Pablo Arias [Espagne] ; Jamile Vivas [Espagne] ; Kenneth L. Grieve [Espagne, Royaume-Uni] ; Javier Cudeiro [Espagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2010-09-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Double-Blind Method, Humans, Low frequency, Motor Cortex, Nervous system diseases, Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Patient Selection, Recovery, Repetitive stimulus, Sign, TMS, Transcranial Magnetic Stimulation (methods), Transcranial magnetic stimulation, Treatment, Treatment Outcome, motor recovery, therapy.
- MESH :
- methods : Transcranial Magnetic Stimulation.
- therapy : Parkinson Disease.
- Double-Blind Method, Humans, Motor Cortex, Patient Selection, Treatment Outcome.
Abstract
We evaluated the effect of low‐frequency rTMS on motor signs in Parkinson's disease (PD), under a double‐blind placebo‐controlled trial design. PD patients were randomly assigned to received either real (n = 9) or sham (n = 9) rTMS for 10 days. Each session comprises two trains of 50 stimuli each delivered at 1 Hz and at 90% of daily rest motor threshold using a large circular coil over the vertex. The effect of the stimulation, delivered during the ON‐period, was evaluated during both ON and OFF periods. Tests were carried out before and after the stimulation period, and again 1 week after. The effect of the stimulation was evaluated through several gait variables (cadence, step amplitude, velocity, the CVstride‐time, and the turn time), hand dexterity, and also the total and motor sections of the UPDRS. Only the total and motor section of the UPDRS and the turn time during gait were affected by the stimulation, the effect appearing during either ON or OFF evaluation, and most importantly, equally displayed in both real and sham group. The rest of the variables were not influenced. We conclude the protocol of stimulation used, different from most protocols that apply larger amount of stimuli, but very similar to some previously reported to have excellent results, has no therapeutic value and should be abandoned. This contrasts with the positive reported effects using higher frequency and focal coils. Our work also reinforces the need for sham stimulation when evaluating the therapeutic effect of rTMS. © 2010 Movement Disorder Society
Url:
DOI: 10.1002/mds.23055
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<front><div type="abstract" xml:lang="en">We evaluated the effect of low-frequency rTMS on motor signs in Parkinson's disease (PD), under a double-blind placebo-controlled trial design. PD patients were randomly assigned to received either real (n = 9) or sham (n = 9) rTMS for 10 days. Each session comprises two trains of 50 stimuli each delivered at 1 Hz and at 90% of daily rest motor threshold using a large circular coil over the vertex. The effect of the stimulation, delivered during the ON-period, was evaluated during both ON and OFF periods. Tests were carried out before and after the stimulation period, and again 1 week after. The effect of the stimulation was evaluated through several gait variables (cadence, step amplitude, velocity, the CV<sub>stride-time</sub>
, and the turn time), hand dexterity, and also the total and motor sections of the UPDRS. Only the total and motor section of the UPDRS and the turn time during gait were affected by the stimulation, the effect appearing during either ON or OFF evaluation, and most importantly, equally displayed in both real and sham group. The rest of the variables were not influenced. We conclude the protocol of stimulation used, different from most protocols that apply larger amount of stimuli, but very similar to some previously reported to have excellent results, has no therapeutic value and should be abandoned. This contrasts with the positive reported effects using higher frequency and focal coils. Our work also reinforces the need for sham stimulation when evaluating the therapeutic effect of rTMS.</div>
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<sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Controlled trial on the effect of 10 days low‐frequency repetitive transcranial magnetic stimulation (rTMS) on motor signs in Parkinson's disease</title>
<author><name sortKey="Arias, Pablo" sort="Arias, Pablo" uniqKey="Arias P" first="Pablo" last="Arias">Pablo Arias</name>
<affiliation wicri:level="1"><country xml:lang="fr">Espagne</country>
<wicri:regionArea>Neuroscience and Motor Control Group (NEUROcom), Department of Medicine‐INEF and Institute for Biomedical Research (INIBIC), University of A Coruña</wicri:regionArea>
<wicri:noRegion>University of A Coruña</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Vivas, Jamile" sort="Vivas, Jamile" uniqKey="Vivas J" first="Jamile" last="Vivas">Jamile Vivas</name>
<affiliation wicri:level="1"><country xml:lang="fr">Espagne</country>
<wicri:regionArea>Neuroscience and Motor Control Group (NEUROcom), Department of Medicine‐INEF and Institute for Biomedical Research (INIBIC), University of A Coruña</wicri:regionArea>
<wicri:noRegion>University of A Coruña</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Grieve, Kenneth L" sort="Grieve, Kenneth L" uniqKey="Grieve K" first="Kenneth L." last="Grieve">Kenneth L. Grieve</name>
<affiliation wicri:level="1"><country xml:lang="fr">Espagne</country>
<wicri:regionArea>Neuroscience and Motor Control Group (NEUROcom), Department of Medicine‐INEF and Institute for Biomedical Research (INIBIC), University of A Coruña</wicri:regionArea>
<wicri:noRegion>University of A Coruña</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Faculty of Life Sciences (Neurosciences), The University of Manchester, Manchester</wicri:regionArea>
<placeName><settlement type="city">Manchester</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Manchester</region>
</placeName>
<orgName type="university">Université de Manchester</orgName>
</affiliation>
</author>
<author><name sortKey="Cudeiro, Javier" sort="Cudeiro, Javier" uniqKey="Cudeiro J" first="Javier" last="Cudeiro">Javier Cudeiro</name>
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<wicri:regionArea>Neuroscience and Motor Control Group (NEUROcom), Department of Medicine‐INEF and Institute for Biomedical Research (INIBIC), University of A Coruña</wicri:regionArea>
<wicri:noRegion>University of A Coruña</wicri:noRegion>
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<monogr></monogr>
<series><title level="j">Movement Disorders</title>
<title level="j" type="abbrev">Mov. Disord.</title>
<idno type="ISSN">0885-3185</idno>
<idno type="eISSN">1531-8257</idno>
<imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher>
<pubPlace>Hoboken</pubPlace>
<date type="published" when="2010-09-15">2010-09-15</date>
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<biblScope unit="issue">12</biblScope>
<biblScope unit="page" from="1830">1830</biblScope>
<biblScope unit="page" to="1838">1838</biblScope>
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<idno type="DOI">10.1002/mds.23055</idno>
<idno type="ArticleID">MDS23055</idno>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Double-Blind Method</term>
<term>Humans</term>
<term>Motor Cortex</term>
<term>Parkinson Disease (therapy)</term>
<term>Parkinson's disease</term>
<term>Patient Selection</term>
<term>TMS</term>
<term>Transcranial Magnetic Stimulation (methods)</term>
<term>Treatment Outcome</term>
<term>motor recovery</term>
<term>therapy</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Transcranial Magnetic Stimulation</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Double-Blind Method</term>
<term>Humans</term>
<term>Motor Cortex</term>
<term>Patient Selection</term>
<term>Treatment Outcome</term>
</keywords>
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<langUsage><language ident="en">en</language>
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<front><div type="abstract" xml:lang="en">We evaluated the effect of low‐frequency rTMS on motor signs in Parkinson's disease (PD), under a double‐blind placebo‐controlled trial design. PD patients were randomly assigned to received either real (n = 9) or sham (n = 9) rTMS for 10 days. Each session comprises two trains of 50 stimuli each delivered at 1 Hz and at 90% of daily rest motor threshold using a large circular coil over the vertex. The effect of the stimulation, delivered during the ON‐period, was evaluated during both ON and OFF periods. Tests were carried out before and after the stimulation period, and again 1 week after. The effect of the stimulation was evaluated through several gait variables (cadence, step amplitude, velocity, the CVstride‐time, and the turn time), hand dexterity, and also the total and motor sections of the UPDRS. Only the total and motor section of the UPDRS and the turn time during gait were affected by the stimulation, the effect appearing during either ON or OFF evaluation, and most importantly, equally displayed in both real and sham group. The rest of the variables were not influenced. We conclude the protocol of stimulation used, different from most protocols that apply larger amount of stimuli, but very similar to some previously reported to have excellent results, has no therapeutic value and should be abandoned. This contrasts with the positive reported effects using higher frequency and focal coils. Our work also reinforces the need for sham stimulation when evaluating the therapeutic effect of rTMS. © 2010 Movement Disorder Society</div>
</front>
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