Клинические и нейрофизиологические эффекты терапевтической сочетанной высокочастотной ритмической транскраниальной магнитной стимуляции моторной и лобной коры при болезни Паркинсона

Translated title of the contribution: Clinical and neurophysiological effects of dual-target high-frequency rtms over the primary motor and prefrontal cortex in Parkinson’s disease

L. I. Aftanas, I. V. Brack, K. I. Kulikova, E. A. Filimonova, S. S. Dzemidovich, M. A. Piradov, N. A. Suponeva, A. G. Poidasheva

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Objective. To evaluate therapeutic effects of navigational dual-target high-frequency rTMS over the primary motor (M1, bilateral) and the left dorsolateral prefrontal cortex (DLPFC) on clinical dynamics of Parkinson’s disease (PD) symptoms in a parallel placebo-controlled study. Material and methods. The study included 46 patients randomized into equal therapeutic and placebo rTMS groups. Navigational therapeutic and placebo10 Hz rTMS was applied over the M1 and DLPFC areas (20 daily sessions, for 3 weeks). Assessment of the dynamics of clinical symptoms was performed using the MDS UPDRS scale (Parts I—IV) before the first session, immediately after 20 sessions, and 4—6 weeks after the rTMS course. Non-motor and mental symptoms were assessed using the Hamilton Depression Rating Scale (HDRS-17), Beck depression inventory (BDI-II), Depression, Anxiety and Stress (DASS-21) scales and the Mini Mental State Examination (MMSE). Results. Significant therapeutic effects of rTMS compared to placebo were established: a greater decrease in overall score on the MDS-UPDRS scale (parts I—IV), a decrease in the severity of non-motor (part I) and motor symptoms (part III, with a large therapeutic effect for the symptoms of rigidity, bradykinesia and postural instability), as well as the severity of motor complications of dopamine replacement therapy (part IV). The effects of rTMS on motor symptoms persisted 4 weeks after the end of the stimulation course. It is also important to note significant positive dynamics in both rTMS and placebo groups in the form of comparable reduction in the severity of everyday motor symptoms (MDS-UPDRS part II), improvement of the total scores on MMSE, HDRS, BDI-II, DASS-21. Conclusions. The dual-target high-frequency rTMS over the primary motor cortex (bilateral) and the left dorsolateral prefrontal cortex has positive therapeutic effects on the motor and affective symptoms of Parkinson’s disease, which are significantly stronger than that of the placebo stimulation.

Translated title of the contributionClinical and neurophysiological effects of dual-target high-frequency rtms over the primary motor and prefrontal cortex in Parkinson’s disease
Original languageRussian
Pages (from-to)29-36
Number of pages8
JournalZhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova
Volume120
Issue number5
DOIs
Publication statusPublished - 1 May 2020

Keywords

  • Dorsolateral prefrontal cortex
  • Motor cortex
  • Motor symptoms
  • Navigational rhythmic transcranial magnetic stimulation (nrTMS)
  • Parkinson’s disease

OECD FOS+WOS

  • 3.02 CLINICAL MEDICINE

State classification of scientific and technological information

  • 76 MEDICINE AND HEALTH CARE

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