Exploring the therapeutic and rehabilitative role of transcranial magnetic stimulation in multiple sclerosis.

Abstract

Multiple sclerosis (MS) is a chronic, autoimmune and neurodegenerative disease characterized by inflammation, lesions, demyelination, and axonal damage. Approximately 2.8 million people globally have MS. Many pharmacological agents can reduce relapsing-remitting episodes, but are ineffective on secondary progressive MS, causing symptoms to worsen over time. MS patients have significant impairment in neurophysiological factors such as demyelination and the balance between inhibitory and excitatory synaptic interactions. These impairments disrupt normal communication between neurons in the cerebral cortex, which contributes to the symptoms and disease progression. Transcranial Magnetic Stimulation (TMS) can identify and measure such neurophysiological parameters, including cortical excitability, linked with progression and the severity of disease. Thus, TMS could serve as a potential surrogate marker to monitor MS activity and severity. The review highlights the potential of TMS in managing MS, including enhanced cognitive functions, reduced fatigue, and improved spasticity, balance, and gait. In addition, TMS contributes to reducing neuroinflammation and oxidative stress while promoting neuronal repair and remyelination. However, further research is required for a better understanding of the stimulation- and site-specific effects of TMS in MS.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/graphical-abstract-25.jpg.