A Randomized Controlled Trial of the Effect of Repetitive Transcranial Magnetic Stimulation of the Motor Cortex on Lower Extremity Spasticity in Hereditary Spastic Paraplegia

Bastani, Pouya B; Kordjazi, Mohsen; Oveisgharan, Shahram; Abdi, Salman

doi:10.1097/wnp.0000000000000874

Cited by 5 publications

(4 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The outcome measures were heterogeneous, with no consistency between studies despite six studies aiming to evaluate spasticity in response to the intervention. The most common outcome measures used were the 10MWT and modified Ashworth score, with two positive studies showing a significant improvement in MAS with treatment [ 62 , 63 ]. Study durations were generally short—only one study had a duration of more than 6 months [ 64 ].…”

Section: Resultsmentioning

confidence: 99%

Outcome Measures and Biomarkers for Clinical Trials in Hereditary Spastic Paraplegia: A Scoping Review

Siow,

Yeow,

Rudaks

et al. 2023

Genes

View full text Add to dashboard Cite

Hereditary spastic paraplegia (HSP) is characterized by progressive lower limb spasticity. There is no disease-modifying treatment currently available. Therefore, standardized, validated outcome measures to facilitate clinical trials are urgently needed. We performed a scoping review of outcome measures and biomarkers for HSP to provide recommendations for future studies and identify areas for further research. We searched Embase, Medline, Scopus, Web of Science, and the Central Cochrane database. Seventy studies met the inclusion criteria, and eighty-three outcome measures were identified. The Spastic Paraplegia Rating Scale (SPRS) was the most widely used (27 studies), followed by the modified Ashworth Scale (18 studies) and magnetic resonance imaging (17 studies). Patient-reported outcome measures (PROMs) were infrequently used to assess treatment outcomes (28% of interventional studies). Diffusion tensor imaging, gait analysis and neurofilament light chain levels were the most promising biomarkers in terms of being able to differentiate patients from controls and correlate with clinical disease severity. Overall, we found variability and inconsistencies in use of outcome measures with a paucity of longitudinal data. We highlight the need for (1) a standardized set of core outcome measures, (2) validation of existing biomarkers, and (3) inclusion of PROMs in HSP clinical trials.

show abstract

Section: Resultsmentioning

confidence: 99%

Outcome Measures and Biomarkers for Clinical Trials in Hereditary Spastic Paraplegia: A Scoping Review

Siow,

Yeow,

Rudaks

et al. 2023

Genes

View full text Add to dashboard Cite

show abstract

“…Although one trial, involving eight patients, showed improvements in lower limb spasticity, secondary outcomes such as lower limb motor function and short-term quality of life improvements did not significantly differ between treatment and control groups. 127 In the other trial, leg muscle strength improved, but spasticity in distal leg muscles did not significantly change. 126 Although there was speculation that rTMS could be paired with gait training to achieve greater functional improvements, an RCT on gait-adaptability training for HSP patients did not show significant benefits.…”

Section: Current and Emerging Therapeutic Targets And Management Stra...mentioning

confidence: 91%

Hereditary spastic paraplegia: Novel insights into the pathogenesis and management

Awuah,

Tan,

Shkodina

et al. 2023

SAGE Open Medicine

View full text Add to dashboard Cite

Hereditary spastic paraplegia is a genetically heterogeneous neurodegenerative disorder characterised primarily by muscle stiffness in the lower limbs. Neurodegenerative disorders are conditions that result from cellular and metabolic abnormalities, many of which have strong genetic ties. While ageing is a known contributor to these changes, certain neurodegenerative disorders can manifest early in life, progressively affecting a person’s quality of life. Hereditary spastic paraplegia is one such condition that can appear in individuals of any age. In hereditary spastic paraplegia, a distinctive feature is the degeneration of long nerve fibres in the corticospinal tract of the lower limbs. This degeneration is linked to various cellular and metabolic processes, including mitochondrial dysfunction, remodelling of the endoplasmic reticulum membrane, autophagy, abnormal myelination processes and alterations in lipid metabolism. Additionally, hereditary spastic paraplegia affects processes like endosome membrane trafficking, oxidative stress and mitochondrial DNA polymorphisms. Disease-causing genetic loci and associated genes influence the progression and severity of hereditary spastic paraplegia, potentially affecting various cellular and metabolic functions. Although hereditary spastic paraplegia does not reduce a person’s lifespan, it significantly impairs their quality of life as they age, particularly with more severe symptoms. Regrettably, there are currently no treatments available to halt or reverse the pathological progression of hereditary spastic paraplegia. This review aims to explore the metabolic mechanisms underlying the pathophysiology of hereditary spastic paraplegia, emphasising the interactions of various genes identified in recent network studies. By comprehending these associations, targeted molecular therapies that address these biochemical processes can be developed to enhance treatment strategies for hereditary spastic paraplegia and guide clinical practice effectively.

show abstract

“…In another study, 8 patients were randomly assigned to receive real ( n = 4) or sham ( n = 4) high-frequency rTMS over the vertex. rTMS was performed during five daily sessions at a fixed frequency of 5 Hz by an eight-figure-shaped coil [ 41 ]. Every session consisted of 5 trains lasting 1 min (1500 pulses per session), while sham stimulation was performed by placing the coil perpendicular to the scalp.…”

Section: Non-invasive Stimulation Techniquesmentioning

confidence: 99%

Non-pharmacological treatment of hereditary spastic paraplegia: a systematic review

Maccora,

Torrente,

Di Stefano

et al. 2023

Neurol Sci

View full text Add to dashboard Cite

A Randomized Controlled Trial of the Effect of Repetitive Transcranial Magnetic Stimulation of the Motor Cortex on Lower Extremity Spasticity in Hereditary Spastic Paraplegia

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 5 publications

References 44 publications

Outcome Measures and Biomarkers for Clinical Trials in Hereditary Spastic Paraplegia: A Scoping Review

Outcome Measures and Biomarkers for Clinical Trials in Hereditary Spastic Paraplegia: A Scoping Review

Hereditary spastic paraplegia: Novel insights into the pathogenesis and management

Non-pharmacological treatment of hereditary spastic paraplegia: a systematic review

Contact Info

Product

Resources

About