The Effect of Repetitive Transcranial Magnetic Stimulation on Spasticity in Patients with Multiple Sclerosis

Abstract

Background and PurposeThis randomized controlled study examined the effect of repetitive transcranial magnetic stimulation (rTMS) on spasticity in patients with multiple sclerosis (MS).MethodsThis study included 16 patients with a history of MS and spasticity in the adductor hip muscles according to the Modified Ashworth Scale (MAS). The participants were randomized into the active group (n=10) and control group (n=6), in which active rTMS and sham rTMS were applied in 10 sessions, respectively. A physical therapy and rehabilitation program was applied along with rTMS sessions in both groups. The evaluation parameters were assessed at baseline and then 1 week and 1 month after applying rTMS.ResultsStatistical analyses with post-hoc correction revealed statistically significant improvements in the active group compared to the control group in the bilateral MAS score, Penn Spasm Frequency Scale score, patient satisfaction, amount of urine leakage, actual health status, perceived health status, energy and fatigue, role limitations due to physical problems, social function, overall quality of life, cognitive functioning, physical health composite score, mental health composite score, and total score on the Multiple Sclerosis Quality of Life-54 (MSQOL-54) (p<0.05). Statistically significant changes were detected in the MSQOL-54 social function and physical health composite scores of patients in the control group (p<0.05).ConclusionsActive rTMS combined with a physical therapy program reduced spasticity in MS patients compared to the control group that received only physical therapy. Further comprehensive and more advanced studies are needed to confirm the present findings.

The Effects of Repetitive Transcranial Magnetic Stimulation on Cognitive Impairment and the Brain Lipidome in a Cuprizone-Induced Mouse Model of Demyelination

“…White matter integrity and function is a predictor for the treatment response of rTMS for PTSD and MDD ( Barredo et al, 2019 ), and low-intensity TMS promote the survival and maturation of newborn oligodendrocytes in the adult mouse brain ( Cullen et al, 2019 ). Moreover, rTMS has also been shown to be beneficial in treating demyelinating disorders, such as Alzheimer’s disease and multiple sclerosis ( San et al, 2019 ; Chou et al, 2020 ); thus, the protective effects of myelin might be involved in the beneficial effects of rTMS.…”

Effects of non-invasive brain stimulation in multiple sclerosis: systematic review and meta-analysis

“…Twenty-five RCTs were identified as suitable for inclusion into the present review, and 23 RCTs were included in the meta-analysis (see Figure 1). 22–46 For details, see Supplementary Materials.…”

“…Patients in three studies received no pharmacological treatment except for interferon-beta, 26,30,40 while patients in five other studies were on stable pharmacological treatment. 23,24,37,39,42 The remaining 17 studies did not provide information on pharmacological treatment.…”

Effects of Repetitive Transcranial Magnetic Stimulation on Upper Extremity Spasticity Post-Stroke: A Systematic Review

“…In agreement with Xu et al (2020), the authors found rTMS did not reduce spasticity post-stroke, but the patients reported better MAS outcomes in a before-after scenario 34 . Recently, San et al (2019) showed combining rTMS with a physical therapy intervention reduces spasticity in patients with multiple sclerosis compared to physical therapy intervention alone 49 .…”