Repetitive Transcranial Magnetic Stimulation Therapy in Parkinson’s Disease – Case Presentation

SOURCE: Romanian Journal of Neurology. Conference: 17th Congress of the Romanian Society of Neurology. Bucharest Romania. 18 (Supplement 1) (pp 25), 2019.


AUTHORS: Jemna N.; Verisezan Rosu O.; Popa Livint L.; Cocoi T.; SlAVOACa D.; MuresANU D.F.

OBJECTIVES: There are numerous studies in the literature that emphasize the effect of repetitive transcranial magnetic stimulation (rTMS) in Parkinson’s disease (PD), by reducing the motor impairment. We present here the clinical evolution of a PD patient, treated with rTMS.

METHODS: A 65 years old female patient, diagnosed with stage III Parkinson’s disease three years ago, without any specific medical therapy, presented in our clinic for an alternative approach of her treatment. Our initial evaluation showed a motor UPDRS score of 40 points, a Parkinson’s disease sleep scale (PDSS) score of 90 and a Beck Depression Inventory (BDI) of 28 points. We also performed an eye tracking investigation to measure her saccadic parameters. We applied a rTMS protocol consisting of ten daily sessions of high frequency stimulation on M1 area of both hemispheres, using an eight-shaped coil.

RESULTS:  After 1 month, the scores of UPDRS part III (motor score) decreased from 40 to 27. Also, our patient confirmed the notable improvement of the gait speed and the motor skills. Moreover, the non-motor symptoms like sleep and mood disturbances were significantly better – the PDSS score was 117 and the BDI score was 15 (mild mood disturbance). The eye-tracking results pointed out a decrease of the number of squarewave jerks and a positive trend regarding the values of saccadic latency, speed and amplitude.

CONCLUSIONS: Our results confirm the published data regarding the antiparkinsonian effects of rTMS on motor symptoms. We consider that rTMS could be an appropriate treatment for selected patients.