Clinical mechanisms of repetitive transcranial magnetic stimulation in improving constipation in Parkinson's disease patients through the gut-brain axis.

IF 4.5 2区医学 Q2 GERIATRICS & GERONTOLOGY

Frontiers in Aging Neuroscience Pub Date : 2025-08-05 eCollection Date: 2025-01-01 DOI:10.3389/fnagi.2025.1607791

Qianlan Bo, Yanmin Li, Xiayue Wang, Huijun Wang, Huimiao Liu

{"title":"Clinical mechanisms of repetitive transcranial magnetic stimulation in improving constipation in Parkinson's disease patients through the gut-brain axis.","authors":"Qianlan Bo, Yanmin Li, Xiayue Wang, Huijun Wang, Huimiao Liu","doi":"10.3389/fnagi.2025.1607791","DOIUrl":null,"url":null,"abstract":"Objectives: This study investigates the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) in alleviating constipation in patients with Parkinson's disease (PD) via the gut-brain axis.Methods: Fifty-eight PD patients with constipation, admitted from May 2023 to December 2024, were randomly assigned to an rTMS treatment group or a sham rTMS control group (29 patients each). Chronic constipation severity was assessed using the Chronic Constipation Severity Score (CSS) before and 14 days after treatment. Additional measures included weekly spontaneous bowel movements (SBM), complete spontaneous bowel movements (CSBM), the Bristol Stool Scale (BSS), and serum levels of gut-brain peptides (5-HT, BDNF, VIP) and cytokines (IL-6, IFN-γ, TNF-α, IL-4, IL-10).Results: Baseline characteristics, including CSS scores, were similar between groups (P > 0.05). After 14 days, the study group exhibited significantly lower CSS scores compared to the control group (e.g., CSS post-treatment: study group 4.03 ± 1.01 vs. control group 6.23 ± 1.03, P < 0.001). Both groups showed increased SBM and CSBM frequencies; however, the study group demonstrated significantly higher counts (e.g., CSBM post-treatment: study group 4.67 ± 0.04 vs. control group 4.16 ± 0.06, P < 0.001). BSS scores improved in both groups, with the study group achieving significantly higher scores (P < 0.05). Post-treatment, the study group had significantly higher serum 5-HT (P < 0.001) and BDNF (P = 0.001) levels, and lower VIP levels (P = 0.041) compared to the control group. Cytokine analysis revealed significantly lower pro-inflammatory IL-6 (P < 0.001), IFN-γ (P = 0.034), TNF-α (P < 0.001) and higher anti-inflammatory IL-4 (P < 0.001), IL-10 (P < 0.001) levels in the study group, with corresponding Cohen's d values indicating medium to very large effect sizes.Conclusion: Repetitive transcranial magnetic stimulation effectively improves constipation symptoms in PD patients over a 14 days period. These benefits are associated with favorable modulations of gut-brain peptides and cytokine profiles, suggesting a therapeutic mechanism involving the gut-brain axis. However, direct causality and the long-term effects require further investigation.","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1607791"},"PeriodicalIF":4.5000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361172/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Aging Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fnagi.2025.1607791","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: This study investigates the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) in alleviating constipation in patients with Parkinson's disease (PD) via the gut-brain axis.

Methods: Fifty-eight PD patients with constipation, admitted from May 2023 to December 2024, were randomly assigned to an rTMS treatment group or a sham rTMS control group (29 patients each). Chronic constipation severity was assessed using the Chronic Constipation Severity Score (CSS) before and 14 days after treatment. Additional measures included weekly spontaneous bowel movements (SBM), complete spontaneous bowel movements (CSBM), the Bristol Stool Scale (BSS), and serum levels of gut-brain peptides (5-HT, BDNF, VIP) and cytokines (IL-6, IFN-γ, TNF-α, IL-4, IL-10).

Results: Baseline characteristics, including CSS scores, were similar between groups (P > 0.05). After 14 days, the study group exhibited significantly lower CSS scores compared to the control group (e.g., CSS post-treatment: study group 4.03 ± 1.01 vs. control group 6.23 ± 1.03, P < 0.001). Both groups showed increased SBM and CSBM frequencies; however, the study group demonstrated significantly higher counts (e.g., CSBM post-treatment: study group 4.67 ± 0.04 vs. control group 4.16 ± 0.06, P < 0.001). BSS scores improved in both groups, with the study group achieving significantly higher scores (P < 0.05). Post-treatment, the study group had significantly higher serum 5-HT (P < 0.001) and BDNF (P = 0.001) levels, and lower VIP levels (P = 0.041) compared to the control group. Cytokine analysis revealed significantly lower pro-inflammatory IL-6 (P < 0.001), IFN-γ (P = 0.034), TNF-α (P < 0.001) and higher anti-inflammatory IL-4 (P < 0.001), IL-10 (P < 0.001) levels in the study group, with corresponding Cohen's d values indicating medium to very large effect sizes.

Conclusion: Repetitive transcranial magnetic stimulation effectively improves constipation symptoms in PD patients over a 14 days period. These benefits are associated with favorable modulations of gut-brain peptides and cytokine profiles, suggesting a therapeutic mechanism involving the gut-brain axis. However, direct causality and the long-term effects require further investigation.

Abstract Image

查看原文本刊更多论文

反复经颅磁刺激经肠-脑轴改善帕金森病患者便秘的临床机制

目的：探讨经颅重复磁刺激（rTMS）经肠脑轴缓解帕金森病（PD）患者便秘的临床疗效。方法：将2023年5月至2024年12月收治的58例PD伴便秘患者随机分为rTMS治疗组和假rTMS对照组（各29例）。治疗前和治疗后14天采用慢性便秘严重程度评分（CSS）评估慢性便秘严重程度。其他测量包括每周自发排便（SBM）、完全自发排便（CSBM）、布里斯托大便量表（BSS）和血清肠脑肽（5-HT、BDNF、VIP）和细胞因子（IL-6、IFN-γ、TNF-α、IL-4、IL-10）水平。结果：基线特征，包括CSS评分，两组间相似（P < 0.05）。14天后，研究组的CSS评分明显低于对照组（治疗后的CSS评分：研究组4.03±1.01比对照组6.23±1.03,P < 0.001）。两组均出现SBM和CSBM频率增高；然而，研究组显示出明显更高的计数（例如，治疗后CSBM：研究组4.67±0.04 vs对照组4.16±0.06,P < 0.001）。两组患者的BSS评分均有改善，其中研究组得分显著高于对照组（P < 0.05）。治疗后，研究组血清5-HT （P < 0.001）和BDNF （P = 0.001）水平显著高于对照组，VIP水平显著低于对照组（P = 0.041）。细胞因子分析显示，研究组促炎IL-6 （P < 0.001）、IFN-γ (P = 0.034)、TNF-α (P < 0.001)水平显著降低，抗炎IL-4 （P < 0.001）、IL-10 （P < 0.001）水平显著升高，相应的Cohen's d值表明中等至非常大的效应量。结论：反复经颅磁刺激可有效改善PD患者便秘症状。这些益处与肠脑肽和细胞因子谱的有利调节有关，表明涉及肠脑轴的治疗机制。然而，直接因果关系和长期影响需要进一步调查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Frontiers in Aging Neuroscience GERIATRICS & GERONTOLOGY-NEUROSCIENCES

CiteScore

6.30

自引率

8.30%

发文量

1426

期刊介绍： Frontiers in Aging Neuroscience is a leading journal in its field, publishing rigorously peer-reviewed research that advances our understanding of the mechanisms of Central Nervous System aging and age-related neural diseases. Specialty Chief Editor Thomas Wisniewski at the New York University School of Medicine is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.