Trans-Spinal Theta Burst Magnetic Stimulation in Parkinson's Disease and Gait Disorders

Mov Disord. 2024 Jun;39(6):1048-1053. doi: 10.1002/mds.29776. Epub 2024 Mar 13.

Abstract

Background: Gait disorders in patients with Parkinson's disease (PD) can become disabling with disease progression without effective treatment.

Objectives: To investigate the efficacy of intermittent θ burst trans-spinal magnetic stimulation (TsMS) in PD patients with gait and balance disorders.

Methods: This was a randomized, parallel, double-blind, controlled trial. Active or sham TsMS was applied at third thoracic vertebra with 100% of the trans-spinal motor threshold, during 5 consecutive days. Participants were evaluated at baseline, immediately after last session, 1 and 4 weeks after last session. Primary outcome was Total Timed Up and Go (TUG) values comparing active versus sham phases 1 week after intervention. The secondary outcome measurements consisted of motor, gait and balance scales, and questionnaires for quality of life and cognition.

Results: Thirty-three patients were included, average age 68.5 (6.4) years in active group and 70.3 (6.3) years in sham group. In active group, Total TUG mean baseline was 107.18 (95% CI, 52.1-116.1), and 1 week after stimulation was 93.0 (95% CI, 50.7-135.3); sham group, Total TUG mean baseline was 101.2 (95% CI, 47.1-155.3) and 1 week after stimulation 75.2 (95% CI 34.0-116.4), P = 0.54. Similarly, intervention had no significant effects on secondary outcome measurements. During stimulation period, five patients presented with mild side effects (three in active group and two in sham group).

Discussion: TsMS did not significantly improve gait or balance analysis in patients with PD and gait disorders. The protocol was safe and well tolerated. © 2024 International Parkinson and Movement Disorder Society.

Keywords: Parkinson's disease/parkinsonism; all spinal cord; gait disturbance/ataxia; surgery/stimulation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Double-Blind Method
  • Female
  • Gait / physiology
  • Gait Disorders, Neurologic* / etiology
  • Gait Disorders, Neurologic* / physiopathology
  • Gait Disorders, Neurologic* / therapy
  • Humans
  • Magnetic Field Therapy / methods
  • Male
  • Middle Aged
  • Parkinson Disease* / complications
  • Parkinson Disease* / physiopathology
  • Parkinson Disease* / therapy
  • Postural Balance / physiology
  • Quality of Life
  • Spinal Cord Stimulation / methods
  • Transcranial Magnetic Stimulation / methods
  • Treatment Outcome