Multi-Target Repetitive Transcranial Magnetic Stimulation Improves Freezing of Gait in Parkinson's Disease: A Randomized Controlled Trial

IF 5 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-08-22 DOI:10.1111/cns.70582

Zixuan Zhang, Danyang Liu, Wenjing Song, Jinyu Li, Xi Wang, Peixiao Yin, Yuning Liu, Min Xu, Fujia Li, Yumeng Li, Guiyun Cui, Wei Zhang

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Abstract

Objective

In this randomized, double-blind, sham-controlled trial, we investigated the efficacy of multi-target 10-Hz rTMS targeting both M1 and SMA in alleviating freezing of gait (FOG) in Parkinson's disease (PD) patients.

Methods

Eighty-four PD-FOG patients were randomly assigned (1:1:1:1) to four groups: M1 and SMA group, M1 group, SMA group, and sham group. rTMS was administered once daily for 10 consecutive days. Assessments were conducted at baseline (T0), after the final session (T1), and 30 days posttreatment (T2), using the FOG-Q, UPDRS-III, Timed Up and Go (TUG) Test, Standing-Start 180° Turn (SS-180) Test, and measures of emotion and cognition.

Results

Application of 10-Hz rTMS to bilateral M1 or SMA significantly reduced FOG severity, improved motor function, and alleviated emotional disturbances in PD patients, with effects lasting at least 1 month. Compared to single-target stimulation, multi-target stimulation of M1 and SMA high-frequency rTMS showed more pronounced therapeutic effects across these outcomes. However, no significant cognitive improvements were observed in either the real or sham stimulation groups.

Conclusions

The results of this study indicate that bilateral M1 and SMA 10-Hz rTMS is a promising therapeutic approach, providing new possibilities for clinical treatment.

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多靶点重复经颅磁刺激改善帕金森病的步态冻结：一项随机对照试验

目的在这项随机、双盲、假对照试验中，我们研究了同时靶向M1和SMA的多靶点10-Hz rTMS缓解帕金森病（PD）患者步态冻结（FOG）的疗效。方法84例PD-FOG患者随机分为M1 + SMA组、M1组、SMA组、假手术组。rTMS每日1次，连续10天。在基线（T0）、末次治疗后（T1）和治疗后30天（T2）进行评估，使用FOG-Q、UPDRS-III、计时向上和向前（TUG）测试、站立-启动180°转弯（SS-180）测试以及情绪和认知测量。结果应用10 hz rTMS治疗双侧M1或SMA可显著降低PD患者的FOG严重程度，改善运动功能，缓解情绪障碍，效果持续至少1个月。与单靶点刺激相比，多靶点刺激M1和SMA高频rTMS在这些结果中显示出更明显的治疗效果。然而，无论是真实刺激组还是假刺激组，都没有观察到显著的认知改善。结论双侧M1 - SMA 10hz rTMS是一种很有前景的治疗方法，为临床治疗提供了新的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.