Safety of Deep Repetitive Transcranial Magnetic Stimulation

Safety of Deep Repetitive Transcranial Magnetic Stimulation (drTMS) against Medical Refractory Symptoms in Parkinson Syndromes: First German Real-World Data with a Specific H5 Coil

Journal: Neurology International 2022; 14(4):1024-1035

Authors: C Cont, A Lehto, N Stute, A Galli, C Schulte, V Deer, M Wessler, L Wojtecki

Background:

To date, Deep TMS has shown promising results as an add-on treatment for Parkinson’s disease (PD) but not for non-idiopathic Parkinson Syndromes (PS).

Objective:

To investigate the safety and feasibility of Deep TMS in patients with different Parkinson syndromes and medical refractory symptoms.

Methods:

Multifaceted real-world data (n=21) was retrospectively analyzed for adverse effects as well as short-term effects of the Deep TMS treatment on patients’ self-rated symptom severity and motor, cognitive, and emotional functions. The Deep TMS treatment with H5 Coil included a sequential 1 Hz stimulation of the primary motor cortex contralateral to the symptom-dominant side and a bilateral 10 Hz stimulation of the prefrontal cortex.

Results:

Overall, Deep TMS could be safely administered to patients with different PS and medical refractory symptoms, but large variation was apparent in the rate (0.2±0.2) and severity ratings (on a scale of 0 to 10; 5.4±2.6) of the reported adverse events (AE). None of the AEs lasted beyond the day of stimulation. The treatment significantly decreased the subjective main symptom severity (on a scale of 0 to 10; pre-treatment: 7.2±1.8àpost-treatment: 6.1±2.2; p=0.027). This effect was more pronounced in older patients with PD (r=-0.61, p=0.02). Furthermore, analysis showed an improvement in depression (as measured by BDI-II; pre-treatment: 10.6±7àpost-treatment: 3.6±3.8; p=0.015), but no effect could be established in terms of cognitive performance (p=0.274).

Conclusions:

Deep TMS can be safely administered to patients with PS and medical refractory symptoms and can decrease the subjective motor symptom severity and depression.

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