Low frequency rTMS of the SMA transiently ameliorates peak-dose LID in Parkinson's disease

Livia Brusa, Viviana Versace, Giacomo Koch, Cesare Iani, Paolo Stanzione, Giorgio Bernardi, Diego Centonze

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine whether low-frequency repetitive transcranial magnetic stimulation (rTMS) may modulate l-DOPA-induced dyskinesia (LID) in dyskinetic Parkinson's disease (PD) patients. LID is a severe motor complication in advanced PD patients. The neural mechanisms involved in LID are not clear, and it is apparent that both an excessive decrease in internal pallidus firing and a modification and overactivation of cortical motor and premotor areas are involved in its pathogenesis. Methods: Using low frequency 1 Hz repetitive rTMS we investigated whether decrease of excitability of the supplementary motor area (SMA) may result in modification of LID in PD patients. Furthermore we tested whether it was possible to enhance and/or prolong the beneficial effects of the treatment with repeated sessions of stimulation. Results: We observed that 1 Hz rTMS induced a transient reduction of dyskinesias. A single session of rTMS improved LID, while repeated sessions of stimulation failed to enhance and/or prolong the beneficial effects of the procedure, without causing motor deterioration or other adverse effects. Conclusions: These results suggest that LID may depend on an increased excitability of the SMA. Significance: SMA rTMS is effective in reducing transiently LID, although cannot yet be considered clinically useful.

Original languageEnglish
Pages (from-to)1917-1921
Number of pages5
JournalClinical Neurophysiology
Volume117
Issue number9
DOIs
Publication statusPublished - Sep 2006

Keywords

  • Dyskinesia
  • Involuntary movements
  • l-DOPA
  • Parkinson disease
  • rTMS
  • Transcranial magnetic stimulation

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Sensory Systems
  • Physiology (medical)

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