Clinical Effect on Cortical Reactivity of Theta Burst Versus High-Frequency Repetitive Transcranial Magnetic Stimulation in Parkinson's Disease: A TMS-EEG Study

IF 5 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-09-11 DOI:10.1111/cns.70605

Jiajing Wu, Sheng Zhuang, Yinlian Han, Fan Gao, Chengjie Mao, Jing Chen, Chun-feng Liu

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Abstract

Background

Both high-frequency repeated transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) are believed to enhance cortical excitability. However, clinical comparison of their benefits for motor improvement in Parkinson's disease (PD) as well as their underlying neurophysiological changes remain unelucidated.

Objective

To compare the clinical effect of rTMS versus iTBS on motor improvement and explore their influence on cortical reactivity using resting state electroencephalogram (EEG) and TMS-EEG.

Methods

Idiopathic PD patients were randomized in a single-blind, controlled trial, and received 10 sessions of either 10-Hz rTMS or iTBS applied to the bilateral primary motor cortex (M1). Motor symptoms were evaluated using the Unified Parkinson's Disease Rating Scale. Cortical reactivity was assessed by resting state EEG and TMS-evoked potentials.

Results

Included were 52 PD patients (mean [SD] age 66.2 [5.8] years). Compared to 10 Hz rTMS, iTBS was more efficient in alleviating tremor symptoms. In the iTBS group, the global mean field amplitude of P60 was significantly higher after stimulation over contralateral M1 of the affected side and was inversely correlated with motor improvement. In the 10 Hz rTMS group, the global mean field amplitude of P30 evoked by ipsilateral M1 increased significantly. The combination of oscillation and connectivity of δ frequency in the frontal cortex of PD provided a decent model in predicting iTBS responders at baseline.

Conclusion

Compared with high-frequency rTMS, iTBS applied to M1 was more effective in improving tremor symptoms in PD. The two non-invasive stimulation modalities appear to exert their effects through distinct neurophysiological pathways, as measured by EEG and TMS-EEG.

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高频重复经颅磁刺激对帕金森病皮层反应性的临床影响：一项TMS-EEG研究

高频重复经颅磁刺激（rTMS）和间歇θ波爆发刺激（iTBS）都被认为能增强皮层的兴奋性。然而，它们对帕金森病（PD）运动改善的益处及其潜在的神经生理变化的临床比较仍不清楚。目的通过静息状态脑电图（EEG）和TMS-EEG分析，比较rTMS与iTBS对运动改善的临床效果，探讨其对脑皮层反应性的影响。方法将特发性PD患者随机纳入单盲对照试验，接受10次10 hz rTMS或iTBS（双侧初级运动皮质）治疗。使用统一帕金森病评定量表评估运动症状。通过静息状态脑电图和tms诱发电位评估皮层反应性。结果纳入52例PD患者（平均[SD]年龄66.2[5.8]岁）。与10hz rTMS相比，iTBS在缓解震颤症状方面更有效。在iTBS组中，刺激对侧M1后，P60的整体平均场振幅显著升高，并与运动改善呈负相关。在10 Hz rTMS组，同侧M1诱发的P30的全球平均场振幅显著增加。PD额叶皮层δ频率振荡和连通性的结合为预测iTBS基线反应提供了一个良好的模型。结论与高频rTMS相比，iTBS对PD震颤症状的改善更有效。通过EEG和TMS-EEG测量，两种非侵入性刺激方式似乎通过不同的神经生理途径发挥作用。

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.