Transcranial magnetic stimulation primes the effects of exercise therapy in multiple sclerosis

Francesco Mori, Concetta Ljoka, Elisabetta Magni, Claudia Codecà, Hajime Kusayanagi, Fabrizia Monteleone, Andrea Sancesario, Giorgio Bernardi, Giacomo Koch, Calogero Foti, Diego Centonze

Research output: Contribution to journalArticlepeer-review


Exercise therapy (ET) can be beneficial in disabled multiple sclerosis (MS) patients. Intermittent transcranial magnetic theta burst stimulation (iTBS) induces long-term excitability changes of the cerebral cortex and may ameliorate spasticity in MS. We investigated whether the combination of iTBS and a program of ET can improve motor disability in MS patients. In a double-blind, sham-controlled trial, 30 participants were randomized to three different interventions: iTBS plus ET, sham stimulation plus ET, and iTBS alone. Before and after 2 weeks of treatment, measures of spasticity through the modified Ashworth scale (MAS) and the 88 items Multiple Sclerosis Spasticity Score questionnaire (MSSS-88), fatigue through the Fatigue Severity Scale (FSS), daily living activities (ADL) through the Barthel index and health-related quality of life (HRQoL) through the 54 items Multiple Sclerosis Quality of life inventory (MSQoL-54) were collected. iTBS plus ET reduced MAS, MSSS-88, FSS scores, while in the Barthel index and MSQoL-54, physical composite scores were increased. iTBS alone caused a reduction of the MAS score, while none of the measured scales showed significant changes after sham iTBS plus ET. iTBS associated with ET is a promising tool for motor rehabilitation of MS patients.

Original languageEnglish
Pages (from-to)1281-1287
Number of pages7
JournalJournal of Neurology
Issue number7
Publication statusPublished - Jul 2011


  • LTP
  • Plasticity
  • Quality of life
  • Rehabilitation
  • Spasticity
  • TMS

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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