Journal of Neurology

, Volume 258, Issue 7, pp 1281–1287 | Cite as

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
Original Communication


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.


LTP Plasticity Quality of life Spasticity TMS Rehabilitation 


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Francesco Mori
    • 1
    • 2
  • Concetta Ljoka
    • 3
  • Elisabetta Magni
    • 3
  • Claudia Codecà
    • 1
    • 2
  • Hajime Kusayanagi
    • 1
    • 2
  • Fabrizia Monteleone
    • 1
    • 2
  • Andrea Sancesario
    • 3
  • Giorgio Bernardi
    • 1
    • 2
  • Giacomo Koch
    • 1
    • 2
  • Calogero Foti
    • 3
  • Diego Centonze
    • 1
    • 2
  1. 1.Dipartimento di Neuroscienze, Clinica NeurologicaUniversità Tor VergataRomeItaly
  2. 2.Fondazione Santa Lucia/Centro Europeo per la Ricerca sul Cervello (CERC)RomeItaly
  3. 3.Dipartimento di Sanità Pubblica e Biologia Cellulare, Medicina Fisica e RiabilitativaUniversità Tor VergataRomeItaly

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