Immediate Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation Combined with Task-Specific Training in Individuals with Parkinson’s Disease: a Preliminary Study

Authors

  • Thanakamchokchai J Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy
  • Tretriluxana J Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy
  • Pakaprot N Department of Physiology
  • Pisarnpong A Movement Disorder Clinic, Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
  • Fisher BE Division of Biokinesiology and Physical Therapy, Southern California University, USA

Keywords:

transcranial magnetic stimulation, brain stimulation, bradykinesia, Parkinson’s disease, task performance

Abstract

Objectives: This study examined the immediate effects of a single-session of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) combined with task-specific training (TST) on reach-to-grasp (RTG) performance in individuals with Parkinson’s disease (PD).

Study design: Matched-pair experimental design

Setting: Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University

Subjects: Twenty patients with mild to moderate severity of PD (Hoehn &Yahr stage I-III) participated in the study.

Methods: Participants were allocated into two groups. The experimental group received HF-rTMS to the left-primary motor cortex (M1) combined with TST of RTG, while the control group received only HF-rTMS to left-M1. Before and immediately post intervention, right-hand RTG performance was measured under no barrier and barrier conditions. Additionally, cortical silent period (CSP) was determined to verify the effects of HF-rTMS.

Results: There were no significant differences between the two groups for both RTG performance and CSP duration.  In the control group, there was a significant decrease (p = 0.03) in movement time immediately after HF-rTMS for a barrier condition.  Moreover, significant differences in absolute time to maximum aperture (TAmax) (p = 0.04) and temporal transport-grasp coordination (Tmax) (p = 0.04) were observed. A significantly longer CSP in the control group (p = 0.02) confirmed the effects of HF-rTMS. In contrast, the experimental group showed a significant prolonged in TAmax (p = 0.04) and Tmax (p = 0.05).

Conclusion: The findings in the experimental group indicated that the TST of RTG was not sufficient to augment the effects of HF-rTMS that may be the results of the complex task of RTG performance covering the aspect of RTG execution, planning, and transport-grasp coordination.

Keywords: transcranial magnetic stimulation, brain stimulation, bradykinesia, Parkinson’s disease, task performance

Author Biographies

Thanakamchokchai J, Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy

+66 2 441 5450; Fax: +66 2 441 5454

Tretriluxana J, Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy

 



Pakaprot N, Department of Physiology


Faculty of MedicineSiriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok 10700, Thailand
Email: narawut.pak@mahidol.ac.th
Phone: +66 868864334

Pisarnpong A, Movement Disorder Clinic, Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand

Movement Disorder Clinic, Division of Neurology, Department of Medicine, Faculty of MedicineSiriraj Hospital
Faculty of MedicineSiriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok 10700, Thailand
Email: apisarnpong@yahoo.com
Phone: +66 818454143

Fisher BE, Division of Biokinesiology and Physical Therapy, Southern California University, USA

Division of Biokinesiology and Physical Therapy, Southern California University
1540 Alcazar St., CHP 155, Los Angeles, CA 90089-9006, USA.
Email: bfisher@pt.usc.edu
Phone: (323) 442-2796

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Published

2020-10-28

Issue

Vol. 30 No. 3 (2020): September - December 2020

Section

Original Article