High-Frequency rTMS over the Supplementary Motor Area for Treatment of Parkinson's Disease
Identifieur interne : 001229 ( PascalFrancis/Checkpoint ); précédent : 001228; suivant : 001230High-Frequency rTMS over the Supplementary Motor Area for Treatment of Parkinson's Disease
Auteurs : Masashi Hamada [Japon] ; Yoshikazu Ugawa [Japon] ; Sadatoshi Tsuji [Japon]Source :
- Movement disorders [ 0885-3185 ] ; 2008.
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Abstract
Dysfunction of the basal ganglia-thalamocortical motor circuit is a fundamental model to account for motor symptoms in Parkinson's disease (PD). Using high-frequency repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area (SMA), we investigated whether modulation of SMA excitability engenders therapeutic effects on motor symptoms in PD. In this double-blind placebo-controlled study, 99 patients were enrolled and assigned randomly to SMA-stimulation and sham-stimulation groups. For SMA stimulation, 20 trains of 50 transcranial magnetic stimuli at 5 Hz were delivered at an intensity of 110% active motor threshold for leg muscles in one session. The sham stimulation was 20 trains of electric stimuli given through electrodes fixed on the head to mimic the cutaneous sensation during rTMS. Each session of intervention was carried out once a week for the first 8 weeks. The SMA stimulation, in contrast to the sham stimulation, engendered significant improvements in total scores and motor scores of the Unified Parkinson's Disease Rating Scale. Mean improvements in motor scores were 4.5 points in the SMA-stimulation group and -0.1 points in the sham-stimulation group. Results indicate that 5 Hz rTMS over SMA modestly improves motor symptoms in PD patients; SMA is a potential stimulation site for PD treatment.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">High-Frequency rTMS over the Supplementary Motor Area for Treatment of Parkinson's Disease</title><author><name sortKey="Hamada, Masashi" sort="Hamada, Masashi" uniqKey="Hamada M" first="Masashi" last="Hamada">Masashi Hamada</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, Division of Neuroscience, Graduate School of Medicine, The University of Tokyo</s1><s2>Tokyo</s2><s3>JPN</s3><sZ>1 aut.</sZ></inist:fA14><country>Japon</country><placeName><settlement type="city">Tokyo</settlement></placeName></affiliation></author><author><name sortKey="Ugawa, Yoshikazu" sort="Ugawa, Yoshikazu" uniqKey="Ugawa Y" first="Yoshikazu" last="Ugawa">Yoshikazu Ugawa</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, School of Medicine, Fukushima Medical University</s1><s2>Fukushima</s2><s3>JPN</s3><sZ>2 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Fukushima</wicri:noRegion></affiliation></author><author><name sortKey="Tsuji, Sadatoshi" sort="Tsuji, Sadatoshi" uniqKey="Tsuji S" first="Sadatoshi" last="Tsuji">Sadatoshi Tsuji</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, School of Medicine, University of Occupational and Environmental Health</s1><s2>Kitakyushu</s2><s3>JPN</s3><sZ>3 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Kitakyushu</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">08-0450247</idno><date when="2008">2008</date><idno type="stanalyst">PASCAL 08-0450247 INIST</idno><idno type="RBID">Pascal:08-0450247</idno><idno type="wicri:Area/PascalFrancis/Corpus">001148</idno><idno type="wicri:Area/PascalFrancis/Curation">001B71</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001229</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">High-Frequency rTMS over the Supplementary Motor Area for Treatment of Parkinson's Disease</title><author><name sortKey="Hamada, Masashi" sort="Hamada, Masashi" uniqKey="Hamada M" first="Masashi" last="Hamada">Masashi Hamada</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, Division of Neuroscience, Graduate School of Medicine, The University of Tokyo</s1><s2>Tokyo</s2><s3>JPN</s3><sZ>1 aut.</sZ></inist:fA14><country>Japon</country><placeName><settlement type="city">Tokyo</settlement></placeName></affiliation></author><author><name sortKey="Ugawa, Yoshikazu" sort="Ugawa, Yoshikazu" uniqKey="Ugawa Y" first="Yoshikazu" last="Ugawa">Yoshikazu Ugawa</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, School of Medicine, Fukushima Medical University</s1><s2>Fukushima</s2><s3>JPN</s3><sZ>2 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Fukushima</wicri:noRegion></affiliation></author><author><name sortKey="Tsuji, Sadatoshi" sort="Tsuji, Sadatoshi" uniqKey="Tsuji S" first="Sadatoshi" last="Tsuji">Sadatoshi Tsuji</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, School of Medicine, University of Occupational and Environmental Health</s1><s2>Kitakyushu</s2><s3>JPN</s3><sZ>3 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Kitakyushu</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>High frequency</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Repetitive stimulus</term><term>Supplementary motor area</term><term>Transcranial magnetic stimulation</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Haute fréquence</term><term>Aire motrice supplémentaire</term><term>Traitement</term><term>Stimulus répétitif</term><term>Stimulation magnétique transcrânienne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Dysfunction of the basal ganglia-thalamocortical motor circuit is a fundamental model to account for motor symptoms in Parkinson's disease (PD). Using high-frequency repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area (SMA), we investigated whether modulation of SMA excitability engenders therapeutic effects on motor symptoms in PD. In this double-blind placebo-controlled study, 99 patients were enrolled and assigned randomly to SMA-stimulation and sham-stimulation groups. For SMA stimulation, 20 trains of 50 transcranial magnetic stimuli at 5 Hz were delivered at an intensity of 110% active motor threshold for leg muscles in one session. The sham stimulation was 20 trains of electric stimuli given through electrodes fixed on the head to mimic the cutaneous sensation during rTMS. Each session of intervention was carried out once a week for the first 8 weeks. The SMA stimulation, in contrast to the sham stimulation, engendered significant improvements in total scores and motor scores of the Unified Parkinson's Disease Rating Scale. Mean improvements in motor scores were 4.5 points in the SMA-stimulation group and -0.1 points in the sham-stimulation group. Results indicate that 5 Hz rTMS over SMA modestly improves motor symptoms in PD patients; SMA is a potential stimulation site for PD treatment.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>23</s2></fA05><fA06><s2>11</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>High-Frequency rTMS over the Supplementary Motor Area for Treatment of Parkinson's Disease</s1></fA08><fA11 i1="01" i2="1"><s1>HAMADA (Masashi)</s1></fA11><fA11 i1="02" i2="1"><s1>UGAWA (Yoshikazu)</s1></fA11><fA11 i1="03" i2="1"><s1>TSUJI (Sadatoshi)</s1></fA11><fA14 i1="01"><s1>Department of Neurology, Division of Neuroscience, Graduate School of Medicine, The University of Tokyo</s1><s2>Tokyo</s2><s3>JPN</s3><sZ>1 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neurology, School of Medicine, Fukushima Medical University</s1><s2>Fukushima</s2><s3>JPN</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Neurology, School of Medicine, University of Occupational and Environmental Health</s1><s2>Kitakyushu</s2><s3>JPN</s3><sZ>3 aut.</sZ></fA14><fA17 i1="01" i2="1"><s1>Effectiveness of rTMS on Parkinson's Disease Study Group</s1><s3>JPN</s3></fA17><fA20><s1>1524-1531</s1></fA20><fA21><s1>2008</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000185584200040</s5></fA43><fA44><s0>0000</s0><s1>© 2008 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>44 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>08-0450247</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Dysfunction of the basal ganglia-thalamocortical motor circuit is a fundamental model to account for motor symptoms in Parkinson's disease (PD). Using high-frequency repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area (SMA), we investigated whether modulation of SMA excitability engenders therapeutic effects on motor symptoms in PD. In this double-blind placebo-controlled study, 99 patients were enrolled and assigned randomly to SMA-stimulation and sham-stimulation groups. For SMA stimulation, 20 trains of 50 transcranial magnetic stimuli at 5 Hz were delivered at an intensity of 110% active motor threshold for leg muscles in one session. The sham stimulation was 20 trains of electric stimuli given through electrodes fixed on the head to mimic the cutaneous sensation during rTMS. Each session of intervention was carried out once a week for the first 8 weeks. The SMA stimulation, in contrast to the sham stimulation, engendered significant improvements in total scores and motor scores of the Unified Parkinson's Disease Rating Scale. Mean improvements in motor scores were 4.5 points in the SMA-stimulation group and -0.1 points in the sham-stimulation group. 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