Deep TMS For Parkingson’s Disease

There is currently no effective long-term treatment for Parkinson’s disease (PD), a chronic, degenerative condition. Since it causes non-invasive changes in cortical excitability that last after stimulation and have cumulative effects over time, focal neuromodulation with repetitive transcranial magnetic stimulation (rTMS) has gained more attention in recent years as a promising treatment for many neurological and psychiatric disorders, including Parkinson’s disease (PD).

To investigate the safety and various symptom improvements following a combination of low-frequency primary motor cortex and high-frequency prefrontal cortex (PFC) stimulation utilizing the deep TMS (dTMS) H-coil as a supplement to Parkinson’s disease treatment (PD).  

45 individuals with Parkinson’s disease underwent 14 dTMS sessions, each of which included 15 minutes of 1 Hz stimulation of the primary motor cortex and 15 minutes of 10 Hz stimulation of the PFC. Clinical evaluations were conducted using the Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale, TINETTI, UP&GO, SCOPA, HDRS-21, and Beck Depression Inventory, as well as self-applied daily motor assessment scales before, at the middle of, and at the end of therapy, as well as a follow-up after 30 days.

The treatment was well-tolerated and had no significant negative effects. In all UPDRS subscales (gait speed, depressive symptoms, balance, autonomic symptoms, and a 73% increase in daily ON time), dTMS significantly reduced PD symptoms at the end and at the follow-up.    

Significant improvements in motor, postural, and motivational symptoms were brought on by dTMS, and this could enhance the effects of concomitant levodopa therapy. This study showed that dTMS may have a significantly larger range of positive effects than those previously reported for TMS, including an increase in the benefits of levodopa. This finding suggests that future clinical trials using dTMS should include a wider range of symptom assessments.