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The effects of 1 Hz rTMS preconditioned by tDCS on gait kinematics in Parkinson’s disease

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Hypokinetic gait is a common and very disabling symptom of Parkinson’s disease (PD). Repetitive transcranial magnetic stimulation (rTMS) over the motor cortex has been used with variable effectiveness to treat hypokinesia in PD. Preconditioning rTMS by transcranial direct current stimulation (tDCS) may enhance its effectiveness to treat hypokinetic gait in PD. Three-dimensional kinematic gait analysis was performed (1) prior to, (2) immediately after and (3) 30 min after low-frequency rTMS (1 Hz, 900 pulses, 80 % of resting motor threshold) over M1 contralateral to the more affected body side preconditioned by (1) cathodal, (2) anodal or (3) sham tDCS (amperage: 1 mA, duration: 10 min) in ten subjects with PD (7 females, mean age 63 ± 9 years) and ten healthy subjects (four females, mean age 50 ± 11 years). The effects of tDCS-preconditioned rTMS on gait kinematics were assessed by the following parameters: number of steps, step length, stride length, double support time, cadence, swing and stance phases. Our data suggest a bilateral improvement of hypokinetic gait in PD after 1 Hz rTMS over M1 of the more affected body side preceded by anodal tDCS. In contrast, 1 Hz rTMS alone (preceded by sham tDCS) and 1 Hz rTMS preceded by cathodal tDCS were ineffective to improve gait kinematics in PD. In healthy subjects, gait kinematics was unaffected by either intervention. Preconditioning motor cortex rTMS by tDCS is a promising approach to treat hypokinetic gait in PD.

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Conflict of interest

None of the authors has any financial disclosures regarding the present manuscript.

Full financial disclosures of all authors for the past year:

Stock Ownership in medically related fields: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

Intellectual Property Rights: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

Consultancies: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

Expert Testimony: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

Advisory Boards: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

Employment: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

Partnerships: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

Contracts: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

Honoraria: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

Royalties: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

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Other: Ameli: none; Fisse: none; Sarfeld: none; Fink: none; Nowak: none.

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Authors and Affiliations

  1. Department of Neurology, University of Cologne, Cologne, Germany

    Mitra von Papen, Mirabell Fisse, Anna-Sophia Sarfeld, Gereon R. Fink & Dennis A. Nowak

  2. Institute of Neuroscience and Medicine (INM-3), Cognitive Neurology, Research Centre Jülich, Jülich, Germany

    Gereon R. Fink & Dennis A. Nowak

  3. Klinik Kipfenberg, Neurochirurgische und Neurologische Fachklinik, Kindingerstrasse 13, 85110, Kipfenberg, Germany

    Dennis A. Nowak

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  1. Mitra von Papen
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  2. Mirabell Fisse
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Correspondence to Dennis A. Nowak.

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Mitra von Papen and Mirabell Fisse have contributed equally.

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von Papen, M., Fisse, M., Sarfeld, AS. et al. The effects of 1 Hz rTMS preconditioned by tDCS on gait kinematics in Parkinson’s disease. J Neural Transm 121, 743–754 (2014). https://doi.org/10.1007/s00702-014-1178-2

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  • DOI: https://doi.org/10.1007/s00702-014-1178-2

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