The Effect of Repetitive Transcranial Magnetic Stimulation of the Cerebellum on the Upper Limb Performance in Early Parkinson’s Disease – Pilot Study

Czech version

Authors: E. Minks ¹; R. Mareček ¹; T. Pavlík ³; K. Chroust ³; M. Bareš ^1,2
Authors‘ workplace: LF MU, Brno 1. neurologická klinika FN u sv. Anny v Brně ¹; LF MU, Brno Centrum pro abnormní pohyby a parkinsonismus 1. neurologické kliniky FN u sv. Anny v Brně ²; LF MU, Brno Institut biostatistiky a analýz LF a PřF ³
Published in: Cesk Slov Neurol N 2010; 73/106(1): 32-36
Category: Original Paper

Overview

Objective:
The cerebellum is strongly involved in the motor system. Repetitive transcranial magnetic stimulation (rTMS) of the cerebellum influences the motor output of healthy volunteers. The aim of this study was to investigate whether rTMS of the cerebellum has the potential to affect motion of the upper limbs in Parkinson’s disease.

Materials and methods:
Ten patients in the early stages of Parkinson’s disease took part in the study. Every patient was given one session of rTMS with real stimulation and one session with sham stimulation. A three-month interval was left between sessions. Sequences were randomized and patients were blinded with regard to real/sham stimulation. A frequency of 1 Hz was employed, with a total of 600 pulses, with stimulation targeted on the lateral right cerebellum. Patients performed two motor tests with their fingers and hands both before and after rTMS procedures (9-hole peg test, ball test).

Results:
Results of the ball test revealed a significant improvement (p < 0.05) in performance of the right upper limb with real rTMS (patients required less time for this test after rTMS). A significant difference (p < 0.05) also emerged in this test with left upper limb and sham rTMS (also less time required to complete this test after rTMS). There were no significant difference in 9-hole peg test before and after (real or sham) rTMS and there was no difference in change of duration for motor tests between real and sham rTMS. No adverse event were recorded.

Outcome:
This pilot study did not demonstrate that cerebellar rTMS influenced the motor system of the upper limbs in a group of 10 patients with Parkinson’s disease. This study does, however, testify to the safety and performance of the method employed.

Key words:
repetitive transcranial magnetic stimulation – cerebellum – nucleus dentatus – Parkinson‘s disease

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