Cerebellar theta burst stimulation does not improve freezing of gait in patients with Parkinson's disease

Autor: Alice Nieuwboer, Moniek A. M. Munneke, Ivan Toni, Arno M. Janssen, Dick F. Stegeman, Bastiaan R. Bloem, A.H. Snijders, Jorik Nonnekes, Thomas van der Kraan
Rok vydání: 2017
Předmět:
Male
0301 basic medicine
Cerebellum
Neurology
Parkinson's disease
genetic structures
medicine.medical_treatment
Pyramidal Tracts
Severity of Illness Index
Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12]
Disability Evaluation
0302 clinical medicine
Gait (human)
Theta burst stimulation
Cerebellar hemisphere
111 000 Intention & Action
Theta Rhythm
Original Communication
Freezing of gait
Parkinson Disease
Middle Aged
Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3]
Transcranial Magnetic Stimulation
medicine.anatomical_structure
Female
Psychology
Adult
medicine.medical_specialty
Freezing of upper limbs
Clinical Neurology
Other Research Donders Center for Medical Neuroscience [Radboudumc 0]
Upper Extremity
03 medical and health sciences
medicine
Humans
Gait Disorders
Neurologic
Aged
Pyramidal tracts
Action
intention
and motor control
Perception
Action and Control [DI-BCB_DCC_Theme 2]
medicine.disease
Transcranial magnetic stimulation
030104 developmental biology
Finger tapping
Parkinson’s disease
Neurology (clinical)
Neuroscience
human activities
Psychomotor Performance
030217 neurology & neurosurgery
Zdroj: Journal of Neurology, 264, 963-972
Journal of Neurology
Journal of Neurology, 264, 5, pp. 963-972
ISSN: 0340-5354
Popis: Freezing of gait (FOG) in Parkinson’s disease (PD) likely results from dysfunction within a complex neural gait circuitry involving multiple brain regions. Herein, cerebellar activity is increased in patients compared to healthy subjects. This cerebellar involvement has been proposed to be compensatory. We hypothesized that patients with FOG would have a reduced ability to recruit the cerebellum to compensate for dysfunction in other brain areas. In this study cerebellar activity was modified unilaterally by either excitatory or inhibitory theta burst stimulation (TBS), applied during two separate sessions. The ipsilateral cerebellar hemisphere, corresponding to the body side most affected by PD, was stimulated. Seventeen patients with PD showing ‘off’ state FOG participated. The presence of FOG was verified objectively upon inclusion. We monitored gait and bimanual rhythmic upper limb movements before and directly after TBS. Gait was evaluated with a FOG-provoking protocol, including rapid 360° turns and a 10-m walking test with small fast steps. Upper limb movement performance was evaluated with a repetitive finger flexion–extension task. TBS did not affect the amount of freezing during walking or finger tapping. However, TBS did increase gait speed when walking with small steps, and decreased gait speed when walking as fast as possible with a normal step size. The changes in gait speed were not accompanied by changes in corticospinal excitability of M1. Unilateral cerebellar TBS did not improve FOG. However, changes in gait speed were found which suggests a role of the cerebellum in PD. Electronic supplementary material The online version of this article (doi:10.1007/s00415-017-8479-y) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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