Effects of intermittent theta burst stimulation on spasticity in patients with multiple sclerosis

F. Mori, C. Codecà, H. Kusayanagi, F. Monteleone, L. Boffa, A. Rimano, G. Bernardi, G. Koch, D. Centonze

Research output: Contribution to journalArticlepeer-review


Background and purpose: Spasticity is a common disorder and a major cause of long-term disability in patients with multiple sclerosis (MS). Our aim was to evaluate whether a recently developed repetitive transcranial magnetic stimulation protocol, the intermittent theta burst stimulation (iTBS) is effective in modulating lower limb spasticity in MS patients. Methods: Twenty MS patients were pseudorandomized to undergo a 2-week daily sessions of real or sham iTBS protocol. The H/M amplitude ratio of the Soleus H reflex, a reliable neurophysiological index of spinal excitability and the Modified Ashworth Scale (MAS) for spasticity were evaluated by blinded raters before and after the stimulation protocols. Results: Patients receiving real iTBS showed a significant reduction of H/M amplitude ratio and MAS scores 1 week after the stimulation and persisting up to 2 weeks after the end of stimulation protocol. There were no significant effects for sham stimulation. Conclusions: These results show that iTBS, a safe, non-invasive, well-tolerated and feasible protocol, is a promising tool for the treatment of spasticity in MS.

Original languageEnglish
Pages (from-to)295-300
Number of pages6
JournalEuropean Journal of Neurology
Issue number2
Publication statusPublished - Feb 2010


  • H reflex
  • ITBS
  • Motor-evoked potentials
  • RTMS
  • Stretch reflex
  • Transcranial magnetic stimulation

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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