Clinical effects of repetitive transcranial magnetic stimulation versus acute levodopa challenge in Parkinson’s disease

Repetitive transcranial magnetic stimulation to improve mood and motor function in Parkinson's disease

“…Sixteen studies used standard clinical ratings such as the UPDRS or the HDRS as outcome measure [12,45,46,49,52,53,[58][59][60][61][62][63][64][65][66][67]. For ease of comparison, we have summarized 15 of these 16 studies in two tables according to the site of stimulation -primary motor cortex (Table 1) and prefrontal or premotor regions ( Table 2).…”

“…Three sham-controlled studies investigated the shortterm effect of rTMS on the motor section of the UPDRS [45,58,64] (Table 1A). The sham condition consisted of stimulation with the TMS coil held at a different (presumably not or at least less effective) angle to the skull [58], stimulation at a different site on the skull (i.e.…”

Transcranial Magnetic Stimulation Treatment for Motor Symptoms in Parkinson’s Disease: A Review of Two Decades of Studies

“…Nine studies [32][33][34]39,45,52,54,55,63] tested the effects of only one rTMS session, while the remaining administered a higher number of sessions, ranging from 2 to 20. Most studies, especially those targeting M1, SMA and DLPFC, administered high-frequency stimulation (24 of 40 studies) [29][30][31][32][33][34][37][38][40][41][42][43][44][49][50][51][53][54][55][57][58][60][61][62], while lowfrequency stimulation was employed primarily in studies targeting other regions. The intensity of stimulation ranged from 20% of motor threshold to 120%.…”

“…Sample sizes were generally under 30 subjects, except for five studies [36,40,57,58,64]. In regard to outcome measures, the Unified Parkinson's Disease Rating Scale -Section III (UPDRS-III) was the most employed measure (33 of 40 studies) [32][33][34][36][37][38][39][40][41][42][43][44][47][48][49][50][51][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68], yet some studies employed other motor function measures such as movement and reaction time [29,30,35], Grooved Pegboard test for fine movement [31], pointing, pronation supination, Purdue Pegboard Test [45], movement frequency [46] and gait kinematics [52].…”

Het beloningssysteem in de hersenen: weten, meten en ingrijpen

“…Parkinsonpatie¨nten hadden minder last van hun symptomen (verlaagde UPDRS (Unified Parkinson's Disease Rating Scale, een referentieschaal waarop de mate van parkinsonisme wordt uitgedrukt))score na TMS van motorcortex en frontale cortex (Shimamoto et al, 2001;Bornke et al, 2004).…”