Transcranial magnetic stimulation and gait disturbances in Parkinson's disease: A systematic review
| Autor: | Leopold Saltuari, Luca Carnicelli, Raffaele Nardone, Luca Sebastianelli, Eugen Trinka, Francesco Brigo, Stefan Golaszewski, Viviana Versace |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Gait disturbances Parkinson's disease medicine.medical_treatment Repetitive transcranial magnetic stimulation Prefrontal Cortex 050105 experimental psychology 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Gait (human) Physiology (medical) medicine Humans 0501 psychology and cognitive sciences Gait Disorders Neurologic Supplementary motor area Transcranial direct-current stimulation Freezing of gait business.industry Gait Disturbance 05 social sciences Motor Cortex Parkinson Disease General Medicine medicine.disease Evoked Potentials Motor Transcranial magnetic stimulation medicine.anatomical_structure Treatment Outcome Neurology Brain stimulation Cortical Excitability Neurology (clinical) business 030217 neurology & neurosurgery Motor cortex |
| Popis: | Transcranial magnetic stimulation (TMS) may offer a reliable means of characterizing important pathophysiologic aspects of motor impairments in Parkinson's disease (PD). Moreover, high-frequency repetitive TMS (rTMS), especially if delivered bilaterally over motor cortical regions, can have beneficial effects on parkinsonian motor symptoms. However, only a few studies have investigated the effects of rTMS on freezing of gait (FOG) and other gait disturbances in PD. We aimed at investigating in this narrative review the usefulness of TMS for exploring the pathophysiology of gait impairment and at evaluating the therapeutic effects of rTMS in this context. The combination of rTMS and treadmill training was found to enhance the effect of physical therapy. Use of an H-coil enables stimulation of deep regions of the brain (for example medial prefrontal cortex) and may be used as a target for add-on therapy in the future. In contrast, theta burst stimulation has proven to be ineffective in treating gait disturbances in PD patients. Dual-mode NIBS, in particular preconditioning motor cortex rTMS by transcranial direct current stimulation, might also represent a novel therapeutic approach for patients with gait disturbances. Recent studies suggest that the supplementary motor area could be an appropriate target for brain stimulation when treating PD patients with FOG. Further large sample and well-designed clinical studies are required to evaluate how the possible positive effects of rTMS can be sustained over time and to determine the optimal stimulation protocols including target, stimulation intensity/duration and number of sessions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|