Objective: Modern principles of Parkinson’s Disease (PD) treatment don’t include only pharmacotherapy, but also non-drug methods. Particularly, transcranial magnetic stimulation (TMS) is actively used in the treatment of PD. Neurophysiological parameters of the cerebral cortex are the sensory markers of it’s excitability and inhibition processes and reflect the prognosis of the possibilities of brain cells neuroplasticity

Background: to determine changes of the premotor cortex excitability parameters in patients with PD stage II after a course of TMS treatment

Method: 45 patients with PD stage II according to Hoehn-Yahr were examined. Additionally to basic PD therapy, all patients were prescribed a course of therapeutic TMS sessions in C3, C4 and Cz zones of the brain with a pulse rate of 5 Hz for 8 minutes, 10 sessions per course. Patients were examined using neurophysiological study: determination of the amplitude and latency of the motor evoked potential (MEP), central motor conducting time (CMCT)

Results: before TMS treatment, the MEP amplitude of the premotor cortex was 7.65±1.21 μV on the left and 8.36±1.67 μV on the right brain hemisphere. The latent period of MEP of the premotor cortex was 22.7±0.9 ms on the left and 24.4±1.01 ms on the right, while the sample with facilitation showed a decrease in the latent period of MEP to 17.2±1.23 ms on the left and 18.6±1.87 ms on the right. CMCT was 11.31±1.12 ms on the left and 12.04±0.89 ms on the right.
After the course of TMS there was a statistically significant (p <0,05) increase in the MEP amplitude, which was 13.41±1.45 μV on the left and 15.76±1.81 μV on the right.The latent period of MEP significantly (p <0.05) decreased both in classical MEP and was 19.3±0.76 ms on the left and 19.9±1.23 ms on the right, and in the sample with facilitation with decreasing latency of MEP by 12% on the left and 15% on the right. There was also a significant decrease in CMCT after a course of TMS up to 8.77±1.27 ms on the left and 7.84±1.07 ms on the right.

Conclusion: after a course of therapeutic TMS in the examined patients with Parkinson’s disease stage II, there is a change in the excitability of the premotor cortex bilaterally, which is manifested by a significant increase in the MEP amplitude and a decrease in the latency of MEP and CMCT

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neurophysiological-features-of-the-premotor-cortex-excitability-parameters-after-a-course-of-therapeutic-transcranial-magnetic-stimulation-in-patients-with-parkinsons-disease-stage-ii-living-in-the/