Original Communication

Journal of Neurology

, Volume 258, Issue 7, pp 1281-1287

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

  • Francesco MoriAffiliated withDipartimento di Neuroscienze, Clinica Neurologica, Università Tor VergataFondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC)
  • , Concetta LjokaAffiliated withDipartimento di Sanità Pubblica e Biologia Cellulare, Medicina Fisica e Riabilitativa, Università Tor Vergata
  • , Elisabetta MagniAffiliated withDipartimento di Sanità Pubblica e Biologia Cellulare, Medicina Fisica e Riabilitativa, Università Tor Vergata
  • , Claudia CodecàAffiliated withDipartimento di Neuroscienze, Clinica Neurologica, Università Tor VergataFondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC)
  • , Hajime KusayanagiAffiliated withDipartimento di Neuroscienze, Clinica Neurologica, Università Tor VergataFondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC)
  • , Fabrizia MonteleoneAffiliated withDipartimento di Neuroscienze, Clinica Neurologica, Università Tor VergataFondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC)
  • , Andrea SancesarioAffiliated withDipartimento di Sanità Pubblica e Biologia Cellulare, Medicina Fisica e Riabilitativa, Università Tor Vergata
  • , Giorgio BernardiAffiliated withDipartimento di Neuroscienze, Clinica Neurologica, Università Tor VergataFondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC)
  • , Giacomo KochAffiliated withDipartimento di Neuroscienze, Clinica Neurologica, Università Tor VergataFondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC)
    • , Calogero FotiAffiliated withDipartimento di Sanità Pubblica e Biologia Cellulare, Medicina Fisica e Riabilitativa, Università Tor Vergata
    • , Diego CentonzeAffiliated withDipartimento di Neuroscienze, Clinica Neurologica, Università Tor VergataFondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC) Email author 

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Abstract

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.

Keywords

LTP Plasticity Quality of life Spasticity TMS Rehabilitation