Objective: We aimed to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the improvement of motor function in patients with Parkinson’s disease (PD).

Background: Parkinson’s disease (PD) is a neurodegenerative disorder typically characterized by motor dysfunctions such as bradykinesia, rigidity, tremor, and gait disturbance. Currently, the treatment of PD focuses primarily on pharmacological therapy to alleviate motor symptoms. In this context, repetitive transcranial magnetic stimulation (rTMS) has been applied to enhance motor cortex excitability. Although recent evidence suggests that rTMS is effective in improving PD-related depressive symptoms, there is still a lack of research regarding its impact on the improvement of motor symptoms in PD.

Method: In this multicenter, randomized, sham-controlled crossover study, PD patients received both real and sham stimulation, separated by a minimum 4-to-5 week washout period. Stimulation was delivered using the ATNC-MDD V2 (AT&C, Republic of Korea) targeting the bilateral primary cortex (M1) at 10Hz. Stimulation intensity was set at 90% resting motor threshold. Each session consisted of 2,400 pulses (600 per sites) administered over five consecutive days. Clinical outcomes were assessed using the MDS-Unified Parkinson’s Disease Rating Scales (MDS-UPDRS) part III and Timed Up-and-Go (TUG) score.

Results: We enrolled 12 patients with PD; 7 completed the crossover protocol, while 5 received a single intervention (10 real, 9 sham total). Using ANCOVA with baseline scores as a covariate, the real-stimulation group had a mean MDS-UPDRS III score that 5.7 point lower than that of the sham-stimulation group (95% CI −11.2 to −0.1, p = 0.045). Bradykinesia score showed a 3.8-point greater reduction in the real group (95% CI −6.9 to −0.7, p = 0.020). Non-significant trends for improvement were noted in real-stimulation over sham stimulation for rigidity, tremor, gait, TUG, and Berg Balance Scale following baseline adjustment. (p > 0.1).

Conclusion: In this study, we found that rTMS improves motor function, particularly bradykinesia, in patients with PD. Our findings suggest that rTMS could be considered a viable treatment option for PD patients; however, further large-scale studies are warranted to validate these results.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/efficacy-of-repetitive-transcranial-magnetic-stimulation-for-improving-motor-function-in-parkinsons-disease-a-prospective-multicenter-crossover-study/