BACKGROUND AND PURPOSE: Spasticity is a common disorder and a major cause of long-term disability in patients with multiple sclerosis (MS). Our aim was to evaluate whether a recently developed repetitive transcranial magnetic stimulation protocol, the intermittent theta burst stimulation (iTBS) is effective in modulating lower limb spasticity in MS patients. METHODS: Twenty MS patients were pseudorandomized to undergo a 2-week daily sessions of real or sham iTBS protocol. The H/M amplitude ratio of the Soleus H reflex, a reliable neurophysiological index of spinal excitability and the Modified Ashworth Scale (MAS) for spasticity were evaluated by blinded raters before and after the stimulation protocols. RESULTS: Patients receiving real iTBS showed a significant reduction of H/M amplitude ratio and MAS scores 1 week after the stimulation and persisting up to 2 weeks after the end of stimulation protocol. There were no significant effects for sham stimulation. CONCLUSIONS: These results show that iTBS, a safe, non-invasive, well-tolerated and feasible protocol, is a promising tool for the treatment of spasticity in MS.
BACKGROUND AND PURPOSE:Spasticity is a common disorder and a major cause of long-term disability in patients with multiple sclerosis (MS). Our aim was to evaluate whether a recently developed repetitive transcranial magnetic stimulation protocol, the intermittent theta burst stimulation (iTBS) is effective in modulating lower limb spasticity in MS patients. METHODS: Twenty MS patients were pseudorandomized to undergo a 2-week daily sessions of real or sham iTBS protocol. The H/M amplitude ratio of the Soleus H reflex, a reliable neurophysiological index of spinal excitability and the Modified Ashworth Scale (MAS) for spasticity were evaluated by blinded raters before and after the stimulation protocols. RESULTS:Patients receiving real iTBS showed a significant reduction of H/M amplitude ratio and MAS scores 1 week after the stimulation and persisting up to 2 weeks after the end of stimulation protocol. There were no significant effects for sham stimulation. CONCLUSIONS: These results show that iTBS, a safe, non-invasive, well-tolerated and feasible protocol, is a promising tool for the treatment of spasticity in MS.
Authors: Asli Demirtas-Tatlidede; Catarina Freitas; Jennifer R Cromer; Laura Safar; Dost Ongur; William S Stone; Larry J Seidman; Jeremy D Schmahmann; Alvaro Pascual-Leone Journal: Schizophr Res Date: 2010-12 Impact factor: 4.939
Authors: Asli Demirtas-Tatlidede; Andrew M Vahabzadeh-Hagh; Montserrat Bernabeu; Jose M Tormos; Alvaro Pascual-Leone Journal: J Head Trauma Rehabil Date: 2012 Jul-Aug Impact factor: 2.710
Authors: Christopher M Zapallow; Michael J Asmussen; David A E Bolton; Kevin G H Lee; Mark F Jacobs; Aimee J Nelson Journal: BMC Neurosci Date: 2012-10-31 Impact factor: 3.288