From the Guidelines
Transcranial magnetic stimulation (TMS) is a potentially effective treatment for improving motor symptoms in Parkinson's disease, particularly in terms of tongue movement velocity and distance, as shown in a controlled study by Murdoch et al. 1. The evidence suggests that TMS can modulate neural activity in targeted focal brain regions, leading to improvements in motor function. Specifically, the study by Murdoch et al. 1 found that transcranial stimulation in the left tongue area of the motor strip improves the maximum velocity of tongue movements and distance of tongue movements. This is a significant finding, as it suggests that TMS can be used to improve swallowing function and reduce the risk of dysphagia in patients with Parkinson's disease.
Some key points to consider when using TMS to treat Parkinson's disease include:
- The treatment protocol typically involves sessions of 10-30 minutes, administered several times per week for 2-6 weeks
- The parameters of the treatment may vary based on the specific symptoms being targeted
- TMS is currently considered an adjunctive therapy rather than a replacement for standard treatments like levodopa medication or deep brain stimulation
- Patients should maintain realistic expectations, as TMS may help manage some symptoms but does not address the underlying neurodegenerative process of Parkinson's disease
- Individual responses to TMS can vary significantly, and consultation with a neurologist specializing in movement disorders is essential before pursuing this treatment option.
It is also important to note that while TMS shows promise in treating Parkinson's disease symptoms, the evidence is not yet conclusive, and more research is needed to fully understand its effects and optimal treatment protocols. However, based on the available evidence, TMS can be considered a viable treatment option for patients with Parkinson's disease who are experiencing motor symptoms, particularly those related to swallowing function.
From the Research
Efficacy of Transcranial Magnetic Stimulation (TMS) in Treating Parkinson's Disease
- TMS has been found to be a safe and moderately effective treatment for motor symptoms of Parkinson's disease, with severely impaired patients having the highest benefits 2.
- High-frequency repetitive TMS (rTMS), especially when delivered bilaterally over motor cortical regions, can have beneficial effects on parkinsonian motor symptoms 3.
- The combination of rTMS and treadmill training has been found to enhance the effect of physical therapy, and the use of an H-coil enables stimulation of deep regions of the brain, which may be used as a target for add-on therapy in the future 3.
- A meta-analysis of 20 studies found that rTMS improves motor symptoms for patients with Parkinson's disease, with combinations of rTMS site and frequency, as well as the number of rTMS pulses, being key modulators of rTMS effects 4.
- Another meta-analysis of 21 studies found that rTMS therapy results in mild-to-moderate motor improvements and has the potential to be used as an adjunct therapy for the treatment of Parkinson's disease 5.
Specific Effects of TMS on Motor Symptoms
- TMS has been found to improve motor function in individuals with Parkinson's disease, with significant improvement in the domains of rigor, bradykinesia, and gait 6.
- High-frequency rTMS targeting the primary motor cortex has been found to have a significant effect on reducing motor symptoms 4.
- Low-frequency rTMS applied over other frontal regions has also been found to have a significant effect on reducing motor symptoms 4.
Long-Term Effects and Safety
- The effects of TMS on motor symptoms have been found to persist after 1 month 6.
- TMS has been found to be safe and feasible in an outpatient setting, with no significant adverse effects reported 6.
- Further research is needed to establish the optimal dosing and long-term durability of treatment effects 2.