Functional

2020 ◽  
pp. 1-25
Keyword(s):  
Magnetic Stimulation ◽  
Chronic Back Pain ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Seizure Reduction ◽  
Safety And Efficacy ◽  
The Third ◽  
Therapeutic Value ◽  
Severe Motor ◽  
Unilateral Pallidotomy ◽  
Pars Interna

This chapter discusses pain, movement disorders, epilepsy, dystonia, and neuropsychiatric disorder. The first set of studies examines the efficacy of spinal cord stimulation in managing pain in patients with chronic back pain and extremity pain, chronic pain, and neuropathic pain. The second set of studies evaluates the efficacy of deep brain stimulation of the subthalamic nucleus for the management of severe motor complications of Parkinson’s disease and compares it with ablative options such as unilateral pallidotomy. The third set of studies assesses the therapeutic value of nerve stimulation for patients with refractory epilepsy as well as its impact in seizure reduction. The next study explores the safety and efficacy of bilateral globus pallidus pars interna (GPi) stimulation for cervical dystonia, a complex condition that is often refractory to multiple medical and procedural therapies. Finally, the last study determines whether daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) safely and effectively treats major depressive disorder.

scholarly journals Bilateral Repetitive Transcranial Magnetic Stimulation With the H-Coil in Parkinson's Disease: A Randomized, Sham-Controlled Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Francesca Spagnolo ◽  
Mario Fichera ◽  
Raffaella Chieffo ◽  
Gloria Dalla Costa ◽  
Marco Pisa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Transcranial Magnetic Stimulation ◽  
High Frequency ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Safety And Efficacy ◽  
Affected Side ◽  
End Of Treatment ◽  
Updrs Part

Background: Pilot open-label application of high-frequency repetitive transcranial magnetic stimulation (rTMS) with H-coil in Parkinson's Disease (PD) have shown promising results.Objective: To evaluate safety and efficacy of high-frequency rTMS with H-coil in PD in a double-blind, placebo-controlled, randomized study.Methods: Sixty patients with PD were randomized into 3 groups: M1-PFC (real stimulation on primary motor-M1 and pre-frontal cortices-PFC), M1 (real rTMS on M1, sham on PFC), Sham (apparent stimulation). Primary outcome was baseline-normalized percent improvement in UPDRS part III OFF-therapy at the end of treatment (12 rTMS sessions, 4 weeks). Secondary outcomes were improvement in UPDRS part III sub-scores, timed tests, and neuropsychological tests. Statistical analysis compared improvement following real and sham stimulation at the end of the protocol using either a t-test or a Mann-Whitney test.Results: All patients tolerated the treatment and concluded the study. One patient from M1-PFC group was excluded from the analysis due to newly discovered uncontrolled diabetes mellitus. No serious adverse effect was recorded. At the end of treatment, patients receiving real rTMS (M1-PFC and M1 combined) showed significantly greater improvement compared to sham in UPDRS part III total score (p = 0.007), tremor subscore (p = 0.011), and lateralized sub-scores (p = 0.042 for the more affected side; p = 0.012 for the less affected side). No significant differences have been oserved in safety and efficacy outcomes between the two real rTMS groups. Notably, mild, not-distressing and transient dyskinesias occurred in 3 patients after real rTMS in OFF state.Conclusions: The present findings suggest that high-frequency rTMS with H-coil is a safe and potentially effective procedure and prompt larger studies for validation as add-on treatment in PD.

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