Excitatory Deep Repetitive Transcranial Magnetic Stimulation with H-coil as Add-on Treatment of Motor Symptoms in Parkinson’s Disease: An Open Label, Pilot Study

Background:

Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a potentialtreatment for Parkinson’s disease (PD). H-coils, inducing deeper and wider magneticfields compared to traditional coils, may be potentially useful in PD, characterized by widespread, bilateral involvement of cortico-subcortical circuits.

Objective:

To evaluate the safety of repetitive deep TMS (dTMS) with H-coil as add-on treatment ofmotor symptoms in PD.

Methods:

Twenty-seven PD patients (aged 60.1±6.8 y; PD-duration: 6.3±2.8 y; motor-UPDRS: 39.6±10.1) underwent 12 dTMSsessions over 4 weeks at excitatory (10 Hz) frequency over primary motor (M1) and bilateral prefrontal (PF) regions. Motor UPDRS off therapy was assessed before and after the last dTMS session, together with safety records at each treatment session.

Results:

No drop-outs or adverse events were recorded. Motor UPDRSsignificantly improved after dTMS (10.8 points average reduction; p<0.0001).

Conclusions:

High-frequency dTMSmight be a safe treatment for PD motor symptoms. Further placebo-controlled, randomized studies are warranted.
Motor UPDRS improvement after dTMS. Data are shown as mean standard error (*p<0.001; pairedt-test).

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