Clinical and neurophysiological effects of dual-target high-frequency rTMS over the primary motor and prefrontal cortex in Parkinson’s disease

Aftanas L.I.; Brack I.V.; Kulikova K.I.; Filimonova E.A.; Dzemidovich S.S.; Piradov M.A.; Suponeva N.A.; Poidasheva A.G.

doi:https://doi.org/10.17116/jnevro202012005129

Aftanas L.I.

Research Institute of Physiology and Fundamental Medicine;
Novosibirsk State University, Department of Neurosciences

Brack I.V.

Research Institute of Physiology and Fundamental Medicine

Kulikova K.I.

Research Institute of Physiology and Fundamental Medicine

Filimonova E.A.

Research Institute of Physiology and Fundamental Medicine

Dzemidovich S.S.

Research Institute of Physiology and Fundamental Medicine

Piradov M.A.

Research Center of Neurology

SPIN RSCI: 2860-1689
Scopus AuthorID: 7003731802
ResearcherID: B-4407-2012
ORCID: 0000-0002-6338-0392

Suponeva N.A.

Research Center of Neurology

SPIN RSCI: 3223-6006
Scopus AuthorID: 35773598900
ResearcherID: B-4686-2012
ORCID: 0000-0003-3956-6362

Poidasheva A.G.

Research Center of Neurology

Clinical and neurophysiological effects of dual-target high-frequency rTMS over the primary motor and prefrontal cortex in Parkinson’s disease

Authors:

Aftanas L.I., Brack I.V., Kulikova K.I., Filimonova E.A., Dzemidovich S.S., Piradov M.A., Suponeva N.A., Poidasheva A.G.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(5): 29‑36

DOI: 10.17116/jnevro202012005129

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To cite this article:

Aftanas LI, Brack IV, Kulikova KI, et al. Clinical and neurophysiological effects of dual-target high-frequency rTMS over the primary motor and prefrontal cortex in Parkinson’s disease. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(5):29‑36. (In Russ.)
https://doi.org/10.17116/jnevro202012005129

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)

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OBJECTIVE

To evaluate therapeutic effects of navigational dual-target high-frequency rTMS over the primary motor (M1, bilateral) and the left dorsolateral prefrontal cortex (DLPFC) on clinical dynamics of Parkinson’s disease (PD) symptoms in a parallel placebo-controlled study.

MATERIAL AND METHODS

The study included 46 patients randomized into equal therapeutic and placebo rTMS groups. Navigational therapeutic and placebo10 Hz rTMS was applied over the M1 and DLPFC areas (20 daily sessions, for 3 weeks). Assessment of the dynamics of clinical symptoms was performed using the MDS UPDRS scale (Parts I—IV) before the first session, immediately after 20 sessions, and 4—6 weeks after the rTMS course. Non-motor and mental symptoms were assessed using the Hamilton Depression Rating Scale (HDRS-17), Beck depression inventory (BDI-II), Depression, Anxiety and Stress (DASS-21) scales and the Mini Mental State Examination (MMSE).

RESULTS

Significant therapeutic effects of rTMS compared to placebo were established: a greater decrease in overall score on the MDS-UPDRS scale (parts I—IV), a decrease in the severity of non-motor (part I) and motor symptoms (part III, with a large therapeutic effect for the symptoms of rigidity, bradykinesia and postural instability), as well as the severity of motor complications of dopamine replacement therapy (part IV). The effects of rTMS on motor symptoms persisted 4 weeks after the end of the stimulation course. It is also important to note significant positive dynamics in both rTMS and placebo groups in the form of comparable reduction in the severity of everyday motor symptoms (MDS-UPDRS part II), improvement of the total scores on MMSE, HDRS, BDI-II, DASS-21.

CONCLUSIONS

The dual-target high-frequency rTMS over the primary motor cortex (bilateral) and the left dorsolateral prefrontal cortex has positive therapeutic effects on the motor and affective symptoms of Parkinson’s disease, which are significantly stronger than that of the placebo stimulation.

Keywords:

Parkinson’s disease

motor cortex

dorsolateral prefrontal cortex

motor symptoms

navigational rhythmic transcranial magnetic stimulation (nrTMS)

Authors:

Aftanas L.I.

Research Institute of Physiology and Fundamental Medicine;
Novosibirsk State University, Department of Neurosciences

Brack I.V.

Research Institute of Physiology and Fundamental Medicine

Kulikova K.I.

Research Institute of Physiology and Fundamental Medicine

Filimonova E.A.

Research Institute of Physiology and Fundamental Medicine

Dzemidovich S.S.

Research Institute of Physiology and Fundamental Medicine

Piradov M.A.

Research Center of Neurology

SPIN RSCI: 2860-1689
Scopus AuthorID: 7003731802
ResearcherID: B-4407-2012
ORCID: 0000-0002-6338-0392

Suponeva N.A.

Research Center of Neurology

SPIN RSCI: 3223-6006
Scopus AuthorID: 35773598900
ResearcherID: B-4686-2012
ORCID: 0000-0003-3956-6362

Poidasheva A.G.

Research Center of Neurology

Received:

31.10.2019

Accepted:

15.01.2020

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