OBJECTIVE: To determine whether low-frequency repetitive transcranial magnetic stimulation (rTMS) may modulate l-DOPA-induced dyskinesia (LID) in dyskinetic Parkinson's disease (PD) patients. LID is a severe motor complication in advanced PD patients. The neural mechanisms involved in LID are not clear, and it is apparent that both an excessive decrease in internal pallidus firing and a modification and overactivation of cortical motor and premotor areas are involved in its pathogenesis. METHODS: Using low frequency 1Hz repetitive rTMS we investigated whether decrease of excitability of the supplementary motor area (SMA) may result in modification of LID in PD patients. Furthermore we tested whether it was possible to enhance and/or prolong the beneficial effects of the treatment with repeated sessions of stimulation. RESULTS: We observed that 1Hz rTMS induced a transient reduction of dyskinesias. A single session of rTMS improved LID, while repeated sessions of stimulation failed to enhance and/or prolong the beneficial effects of the procedure, without causing motor deterioration or other adverse effects. CONCLUSIONS: These results suggest that LID may depend on an increased excitability of the SMA. SIGNIFICANCE: SMA rTMS is effective in reducing transiently LID, although cannot yet be considered clinically useful.
OBJECTIVE: To determine whether low-frequency repetitive transcranial magnetic stimulation (rTMS) may modulate l-DOPA-induced dyskinesia (LID) in dyskinetic Parkinson's disease (PD) patients. LID is a severe motor complication in advanced PDpatients. The neural mechanisms involved in LID are not clear, and it is apparent that both an excessive decrease in internal pallidus firing and a modification and overactivation of cortical motor and premotor areas are involved in its pathogenesis. METHODS: Using low frequency 1Hz repetitive rTMS we investigated whether decrease of excitability of the supplementary motor area (SMA) may result in modification of LID in PDpatients. Furthermore we tested whether it was possible to enhance and/or prolong the beneficial effects of the treatment with repeated sessions of stimulation. RESULTS: We observed that 1Hz rTMS induced a transient reduction of dyskinesias. A single session of rTMS improved LID, while repeated sessions of stimulation failed to enhance and/or prolong the beneficial effects of the procedure, without causing motor deterioration or other adverse effects. CONCLUSIONS: These results suggest that LID may depend on an increased excitability of the SMA. SIGNIFICANCE: SMA rTMS is effective in reducing transiently LID, although cannot yet be considered clinically useful.
Authors: Aparna Wagle Shukla; Jonathan J Shuster; Jae Woo Chung; David E Vaillancourt; Carolynn Patten; Jill Ostrem; Michael S Okun Journal: PM R Date: 2015-08-24 Impact factor: 2.298
Authors: Berthold Langguth; Tobias Kleinjung; Elmar Frank; Michael Landgrebe; Philipp Sand; Jana Dvorakova; Ulrich Frick; Peter Eichhammer; Göran Hajak Journal: Exp Brain Res Date: 2007-12-07 Impact factor: 1.972
Authors: Michael D Fox; Randy L Buckner; Hesheng Liu; M Mallar Chakravarty; Andres M Lozano; Alvaro Pascual-Leone Journal: Proc Natl Acad Sci U S A Date: 2014-09-29 Impact factor: 11.205