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


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).


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


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.


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).


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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