The Effect of 20 Hz versus 1 Hz Repetitive Transcranial Magnetic Stimulation on Motor Dysfunction in Parkinson's Disease: Which Is More Beneficial?
The Effect of 20 Hz versus 1 Hz Repetitive Transcranial Magnetic Stimulation on Motor Dysfunction in Parkinson's Disease: Which Is More Beneficial?
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DOI：
10.3233/jpd-181540
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发表时间：
2019-01-01
影响因子：
5.2
通讯作者：
Rothwell, John C.
中科院分区：
文献类型：
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作者：
Khedr, Eman M.;Al-Fawal, Bastawy;Rothwell, John C.
背景资料：有证据表明，高，低频rTMS可能有治疗效果的运动performance帕金森diseases.Objective：本研究的目的是进行第一次直接比较的两approximates.Methods：52例PD患者随机分为两组。第一组接受20 Hz，第二组接受1 Hz rTMS，每个半球的M1上总共有2000个脉冲，持续10天。在最后一次治疗前、治疗后和治疗后一个月，采用统一帕金森病评定量表第三部分（UMRS）、工具性日常生活活动（IADL）和自我评估评分（SA）评估疗效。皮质兴奋性测量之前和结束后的sessions.Results：有一个显着的改善后，无论是1 Hz或20 Hz的rTMS的所有评级量表，但效果持续时间较长后20 Hz（治疗X时间的相互作用，为ECORS和IADL（P = 0.075和0.04，分别）。两种治疗均不影响运动阈值，但20 Hz rTMS增加了MEP振幅和经胼胝体抑制的持续时间。在探索性分析中，将每组再分为运动不能僵硬和震颤显性亚组，并重新计算1 Hz和20 Hz治疗的影响。有微弱的证据表明，患者的运动不能刚性介绍可能会比那些占主导地位的tremet.Conclusion：20 Hz和1 Hz的rTMS改善PD的运动功能，但20 Hz的rTMS更有效。
Background: There is evidence that both high and low frequency rTMS may have therapeutic effects on motor performance of Parkinson's disease.Objective: The aim of the study was to conduct the first direct comparison of the two approaches.Methods: 52 PD patients were randomly classified into two groups. The first group received 20 Hz and the 2nd group received 1 Hz rTMS with a total of 2000 pulses over M1 of each hemisphere for ten days. Effects were assessed with the Unified Parkinson's Disease Rating Scale part III (UPDRS), Instrumental Activity of Daily Living (IADL), and a self assessment score (SA) before, after the last session, and one month later. Cortical excitability was measured before and after the end of sessions.Results: There was a significant improvement on all rating scales after either 1 Hz or 20 Hz rTMS, but the effect persisted for longer after 20 Hz (treatment X time interaction for UPDRS and IADL (P = 0.075 and 0.04, respectively). Neither treatment affected motor thresholds, but 20 Hz rTMS increased MEP amplitude and the duration of transcallosal inhibition. In an exploratory analysis, each group was subdivided into akinetic-rigid and tremor dominant subgroups and the effects of 1 Hz and 20 Hz treatment recalculated. There was weak evidence that patients with an akinetic-rigid presentation may respond better than those with predominant tremor.Conclusion: Both 20 Hz and 1 Hz rTMS improve motor function in PD, but 20 Hz rTMS is more effective.