Category: Parkinson's Disease: Non-Motor Symptoms
Objective: To explore whether repetitive transcranial magnetic stimulation (rTMS) can improve excessive daytime sleepiness (EDS) in individuals with Parkinson’s disease (PD).
Background: Excessive daytime sleepiness is commonly observed in individuals with PD. Repetitive transcranial magnetic stimulation is a promising therapeutic tool for improving non-motor symptoms of PD. However, the efficacy and safety of rTMS in treating EDS in PD was not reported previously.
Method: We conducted a randomized, single-blind, sham-controlled parallel study. A total of 53 individuals with PD received 10 daily sessions of 1-Hz rTMS applied to the right dorsolateral prefrontal cortex (DLPFC). Clinical assessments were completed at baseline, post-treatment, and 1 month after rTMS. Primary outcome was improvement of EDS evaluated via Epworth Sleepiness Scale (ESS) 10 days after treatment. Change of scores on Pittsburgh Sleep Quality Index (PSQI), Hamilton Rating Scale for Depression 17-item (HRSD-17) and Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) were used to evaluate sleep quality, depression severity and motor symptom, respectively, as the secondary outcome.
Results: All participants completed the study and no adverse effect was noticed. Compared to baseline, significant improvement on ESS was observed 10 days after treatment in active rTMS group (9.42 ± 4.98 vs 7.00 ± 4.46; P<0.01). Changes of ESS scores were not significantly related to depression alleviation or motor improvement post-treatment after adjusting for disease duration (r=0.27, P=0.07). A decrease of scores on PSQI and UPDRS-III was observed with marginal significance. No significant changes were noticed in sham rTMS group.
Conclusion: In patients with PD, low frequency rTMS over right DLPFC may have beneficial effect in short term, which effect might be independent of depression or motor symptom improvement.
To cite this abstract in AMA style:
S. Zhuang, JJ. Wu, X. Gu, LX. Wang, XY. Zhang, CJ. Mao, J. Chen, CF. Liu. Improvement of excessive daytime sleepiness with low frequency repetitive transcranial magnetic stimulation in Parkinson’s disease: a preliminary sham-controlled study [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/improvement-of-excessive-daytime-sleepiness-with-low-frequency-repetitive-transcranial-magnetic-stimulation-in-parkinsons-disease-a-preliminary-sham-controlled-study/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/improvement-of-excessive-daytime-sleepiness-with-low-frequency-repetitive-transcranial-magnetic-stimulation-in-parkinsons-disease-a-preliminary-sham-controlled-study/