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Effect of Regional Brain Activity Following Repeat Transcranial Magnetic Stimulation in SCA3: A Secondary Analysis of a Randomized Clinical Trial

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Abstract

Repetitive transcranial magnetic stimulation (rTMS), a noninvasive neuroregulatory technique used to treat neurodegenerative diseases, holds promise for spinocerebellar ataxia type 3 (SCA3) treatment, although its efficacy and mechanisms remain unclear. This study aims to observe the short-term impact of cerebellar rTMS on motor function in SCA3 patients and utilize resting-state functional magnetic resonance imaging (RS-fMRI) to assess potential therapeutic mechanisms. Twenty-two SCA3 patients were randomly assigned to receive actual rTMS (AC group, n = 11, three men and eight women; age 32–55 years) or sham rTMS (SH group, n = 11, three men and eight women; age 26–58 years). Both groups underwent cerebellar rTMS or sham rTMS daily for 15 days. The primary outcome measured was the ICARS scores and parameters for regional brain activity. Compared to baseline, ICARS scores decreased more significantly in the AC group than in the SH group after the 15-day intervention. Imaging indicators revealed increased Amplitude of Low Frequency Fluctuation (ALFF) values in the posterior cerebellar lobe and cerebellar tonsil following AC stimulation. This study suggests that rTMS enhances motor functions in SCA3 patients by modulating the excitability of specific brain regions and associated pathways, reinforcing the potential clinical utility of rTMS in SCA3 treatment. The Chinese Clinical Trial Registry identifier is ChiCTR1800020133.

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Data Availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Acknowledgements

The authors would like to thank the kind patients, families, and caregivers who participated in this research.

Funding

This work was supported by The Joint Funds for the Innovation of Science and Technology Fujian Province to X–Y Chen (No.2021Y9088, Fujian).

Author information

Authors and Affiliations

  1. Department of Rehabilitation Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China

    Xia Liu, Xia-Hua Liu, Xin-Yuan Chen & Shi-Zhong Wang

  2. Department of Radiology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China

    Lin Zhang, Meng-Cheng Li, Xiao-Yue Xia, Zi-Qiang Huang, Na-Ping Chen, Yu-Qing Tu, Jian-Ping Hu & Qun-Lin Chen

  3. Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, 350005, China

    Hao-Lin Xu, Arif Sikandar & Shi-Rui Gan

  4. National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China

    Xin-Yuan Chen

Authors
  1. Xia Liu
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  2. Lin Zhang
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Consortia

Members of the Organization in South-East China for Cerebellar Ataxia Research (OSCCAR)

  • Zhi-Xian Ye
  • , Ru-Ying Yuan
  • , Wei Lin
  • , Liang-Liang Qiu
  • , Min-Ting Lin
  • , Wan-Jin Chen
  • , Ning Wang
  • , Ying Fu
  •  & Shi-Rui Gan

Contributions

XL, LZ, HLX and XYC formulated and designed the study concept; XHL, AS, MCL, XYX, ZQH, NPC, and YQT enrolled the patients and conducted clinical assessments and neuropsychological tests; JPH and QLC conducted imaging data collection; SRG, XYC, QLC and SZW analyzed the data, and interpreted the results; All authors were involved in drafting/revising the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Qun-Lin Chen, Xin-Yuan Chen or Shi-Zhong Wang.

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Ethical Approval

This study is within the framework of a clinical trial (MRCTA, ECFAH OF [2018]201) approved by Local Institutional Review Board. Written informed consent was obtained from the patient for publication of their clinical details, imaging and video data.

Competing Interests

The authors declare no competing interests.

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Xia Liu, Lin Zhang and Hao-Lin Xu these authors share the first authorship of this article.

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Liu, X., Zhang, L., Xu, HL. et al. Effect of Regional Brain Activity Following Repeat Transcranial Magnetic Stimulation in SCA3: A Secondary Analysis of a Randomized Clinical Trial. Cerebellum (2024). https://doi.org/10.1007/s12311-024-01689-8

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  • DOI: https://doi.org/10.1007/s12311-024-01689-8

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