Controlled Trial on the Effect of 10 Days Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Motor Signs in Parkinson's Disease
Identifieur interne : 002383 ( PascalFrancis/Curation ); précédent : 002382; suivant : 002384Controlled 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.
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- Pascal (Inist)
English descriptors
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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.
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Grieve</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Neuroscience and Motor Control Group (NEUROcom), Department of Medicine-INEF and Institute for Biomedical Research (INIBIC), University of A Coruña</s1><s3>ESP</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Espagne</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Faculty of Life Sciences (Neurosciences), The University of Manchester</s1><s2>Manchester</s2><s3>GBR</s3><sZ>3 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Cudeiro, Javier" sort="Cudeiro, Javier" uniqKey="Cudeiro J" first="Javier" last="Cudeiro">Javier Cudeiro</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Neuroscience and Motor Control Group (NEUROcom), Department of Medicine-INEF and Institute for Biomedical Research (INIBIC), University of A Coruña</s1><s3>ESP</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Espagne</country></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="2010">2010</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>Low frequency</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Recovery</term><term>Repetitive stimulus</term><term>Sign</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>Basse fréquence</term><term>Stimulus répétitif</term><term>Stimulation magnétique transcrânienne</term><term>Signe</term><term>Traitement</term><term>Récupération</term></keywords></textClass></profileDesc></teiHeader><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></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>25</s2></fA05><fA06><s2>12</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Controlled Trial on the Effect of 10 Days Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Motor Signs in Parkinson's Disease</s1></fA08><fA11 i1="01" i2="1"><s1>ARIAS (Pablo)</s1></fA11><fA11 i1="02" i2="1"><s1>VIVAS (Jamile)</s1></fA11><fA11 i1="03" i2="1"><s1>GRIEVE (Kenneth L.)</s1></fA11><fA11 i1="04" i2="1"><s1>CUDEIRO (Javier)</s1></fA11><fA14 i1="01"><s1>Neuroscience and Motor Control Group (NEUROcom), Department of Medicine-INEF and Institute for Biomedical Research (INIBIC), University of A Coruña</s1><s3>ESP</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Faculty of Life Sciences (Neurosciences), The University of Manchester</s1><s2>Manchester</s2><s3>GBR</s3><sZ>3 aut.</sZ></fA14><fA20><s1>1830-1838</s1></fA20><fA21><s1>2010</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000194841700080</s5></fA43><fA44><s0>0000</s0><s1>© 2010 INIST-CNRS. 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