Abstract
The motor cortex (MC) receives an excitatory input from the cerebellum which is reduced in patients with cerebellar lesions. High-frequency repetitive transcranial magnetic stimulation (rTMS) induces cortical facilitation which can counteract the reduced cerebellar drive to the MC. Our study included 24 relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS) patients with dysmetria. The patients were divided into two groups: Group A received two sessions of real MC rTMS and Group B received one session of real rTMS and one session of sham rTMS. Ten healthy volunteers formed group C. Evaluation was carried out using the nine-hole pegboard task and the cerebellar functional system score (FSS) of the expanded disability status scale (EDSS). Group A patients showed a significant improvement in the time required to finish the pegboard task (P = 0.002) and in their cerebellar FSS (P = 0.000) directly after the second session and 1 month later. The RRMS patients showed more improvement than the SPMS patients. Group B patients did not show any improvement in the pegboard task or the cerebellar FSS. These results indicate that MC rTMS can be a promising option in treating both RRMS or SPMS patients with cerebellar impairment and that its effect can be long-lasting.
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Abbreviations
- EDSS:
-
Expanded disability status scale
- FSS:
-
Functional system score
- LTP:
-
Long-term potentiation
- LTD:
-
Long-term depression
- MC:
-
Motor cortex
- MEP:
-
Motor-evoked potential
- MS:
-
Multiple sclerosis
- NMDA:
-
N-methyl-D-aspartate
- RRMS:
-
Relapsing-remitting multiple sclerosis
- RMT:
-
Resting motor threshold
- rTMS:
-
Repetitive transcranial magnetic stimulation
- SPMS:
-
Secondary progressive multiple sclerosis
- TMS:
-
Transcranial magnetic stimulation
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Elzamarany, E., Afifi, L., El-Fayoumy, N.M. et al. Motor cortex rTMS improves dexterity in relapsing-remitting and secondary progressive multiple sclerosis. Acta Neurol Belg 116, 145–150 (2016). https://doi.org/10.1007/s13760-015-0540-y
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DOI: https://doi.org/10.1007/s13760-015-0540-y