Trans-Spinal Theta Burst Magnetic Stimulation in Parkinson's Disease and Gait Disorders.

Egberto Reis Barbosa, Manoel Jacobsen Teixeira, Daniel Ciampi de Andrade, Janaína Reis Menezes, Glaucia Aline Nunes, Rafael Bernhart Carra, Juliana da Silva Simões, Davi Jorge Fontoura Solla, Jussan Rodrigues Oliveira, Marco Antônio Marcolin, Clarice Tanaka, Rubens Gisbert Cury

Journal: Movement disorders : official journal of the Movement Disorder Society 2024;39(6):1048-1053

PMID: 38477413

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Abstract

BACKGROUND

Gait disorders in patients with Parkinson's disease (PD) can become disabling with disease progression without effective treatment.

OBJECTIVES

To investigate the efficacy of intermittent θ burst trans-spinal magnetic stimulation (TsMS) in PD patients with gait and balance disorders.

METHODS

This was a randomized, parallel, double-blind, controlled trial. Active or sham TsMS was applied at third thoracic vertebra with 100% of the trans-spinal motor threshold, during 5 consecutive days. Participants were evaluated at baseline, immediately after last session, 1 and 4 weeks after last session. Primary outcome was Total Timed Up and Go (TUG) values comparing active versus sham phases 1 week after intervention. The secondary outcome measurements consisted of motor, gait and balance scales, and questionnaires for quality of life and cognition.

RESULTS

Thirty-three patients were included, average age 68.5 (6.4) years in active group and 70.3 (6.3) years in sham group. In active group, Total TUG mean baseline was 107.18 (95% CI, 52.1-116.1), and 1 week after stimulation was 93.0 (95% CI, 50.7-135.3); sham group, Total TUG mean baseline was 101.2 (95% CI, 47.1-155.3) and 1 week after stimulation 75.2 (95% CI 34.0-116.4), P = 0.54. Similarly, intervention had no significant effects on secondary outcome measurements. During stimulation period, five patients presented with mild side effects (three in active group and two in sham group).

DISCUSSION

TsMS did not significantly improve gait or balance analysis in patients with PD and gait disorders. The protocol was safe and well tolerated. © 2024 International Parkinson and Movement Disorder Society.

Address: Movement Disorders Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.; Functional Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.; Department of Phytotherapy, Speech Therapy and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.; Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.; Movement Disorders Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.; Hospital Israelita Albert Einstein, São Paulo, Brazil.

DOI: 10.1002/mds.29776

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MeSH Terms: Humans, Parkinson Disease, Male, Female, Aged, Middle Aged, Gait Disorders, Neurologic, Double-Blind Method, Postural Balance, Treatment Outcome, Quality of Life, Spinal Cord Stimulation, Transcranial Magnetic Stimulation, Gait, Magnetic Field Therapy