Impact of Repetitive Transcranial Magnetic Stimulation on Neurocognition and Oxidative Stress in Relapsing-Remitting Multiple Sclerosis: A Case Report

Abstract

Multiple sclerosis (MS) is a neurodegenerative condition whose manifestation and clinical evolution can present themselves in very different ways. Analogously, its treatment has to be personalized and the patient's response may be idiosyncratic. At this moment there is no cure for it, in addition to its clinical course sometimes being torpid, with a poor response to any treatment. However, Transcranial Magnetic Stimulation (TMS) has demonstrated its usefulness as a non-invasive therapeutic tool for the treatment of some psychiatric and neurodegenerative diseases. Some studies show that the application of rTMS implies improvement in patients with MS at various levels, but the effects at the psychometric level and the redox profile in blood have never been studied before, despite the fact that both aspects have been related to the severity of MS and its evolution. Here we present the case of a woman diagnosed with relapsing-remitting multiple sclerosis (RRMS) at the age of 33, with a rapid progression of her illness and a poor response to different treatments previously prescribed for 9 years. In view of the patient's clinical course, a compassionate treatment with rTMS for 1 year was proposed. Starting from the fourth month of treatment, when reviewing the status of her disease, the patient denoted a clear improvement at different levels. There followed out psychometric evaluations and blood analyses, that showed both an improvement in her neuropsychological functions and a reduction in oxidative stress in plasma, in correspondence with therTMS treatment.

Clinical application of transcranial magnetic stimulation in multiple sclerosis

“…Therefore, the search for new treatments is particularly important, and TMS is an additional way to treat MS. TMS has outstanding features compared with the existing drug treatment methods in many aspects, especially with fewer side effects. What is more, its safety has been confirmed by many related studies (16,27). Thus, TMS is thought to be a promising new method for the treatment of MS.…”

“…At the same time, it can inhibit the apoptosis pathway of mitochondria, reduce the apoptosis of nerve cells, and play a neuroprotective role ( 41 ). Aguera et al presented the case of a woman diagnosed with MS more than a decade earlier and who was not responding to conventional medications ( 27 ). In view of this, they decided to try a treatment with rTMS for 1 year.…”

Transcranial Magnetic Stimulation in the Treatment of Neurological Diseases

“…Agüera et al ( 141 ) reported a case of RRMS (33 years, female) not responding to medications prescribed over 9 years and rapidly progressing disease. The patient benefited from rTMS which was prescribed as a compassionate treatment as no other treatment was producing any benefit.…”

“…The patient benefited from rTMS which was prescribed as a compassionate treatment as no other treatment was producing any benefit. Post rTMS, there was improvement in her neuropsychological functions and blood tests showed a reduction in oxidative stress after 4 months of treatment ( 141 ).…”

Therapeutic non-invasive brain treatments in Alzheimer’s disease: recent advances and challenges

“…Interestingly, rTMS display its anti-oxidative effects in multiple brain diseases [ 223 , 224 ]. For example, multiple sclerosis patients who received long-term treatment with 1-Hz rTMS showed significant improvement in various levels of psychometric evaluation and blood analysis [ 225 ]. Notably, there is a marked reduction of oxidative stress in the plasma [ 225 ].…”