Objective: This study aimed to investigate the related factors for the response to rTMS in PD patients.

Background: Repetitive transcranial magnetic stimulation (rTMS) is an effective noninvasive neuromodulation technique for Parkinson’s disease (PD). However, the efficacy of rTMS varies widely between individuals.

Method: We retrospectively analyzed the response of 70 idiopathic PD patients who underwent rTMS for 14 consecutive days on the supplementary motor area (SMA) in an open-label trail (n = 31) or a randomized, double-blind, placebo-controlled trial (RCT) (n = 39). The motor symptoms of PD patients were assessed by the United Parkinson’s Disease Rating Scale Part III (UPDRSIII). According to previous studies, the UPDRSIII were divided into six symptom clusters: axial dysfunction, resting tremor, rigidity, bradykinesia affecting right and left extremities, and postural tremor. Then the efficacy of rTMS to different motor symptom clusters and clinical predictors were analyzed in these two trails. The study design is shown in Figure 1.

Results: After 14 days of treatment, only the total scores of UPDRSIII and rigidity scores improved in both the open-label trial and the RCT. The results of RCT are shown in Figure 2

. The results of multiple linear regression analysis showed the baseline rigidity scores (β = 0.37, p=0.047) and RMT (β= 0.30, P = 0.02) positively predicted the improvement of UPDRSIII. The baseline rigidity score (β = 0.55, P < 0.0001) was the independent factor to predict the improvement of rigidity.

Conclusion: This study identified factors related to the response to rTMS in PD patients, providing a basis for individualized rTMS therapy.

Figure 1

Figure 2

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MDS Abstracts - https://www.mdsabstracts.org/abstract/differential-symptom-cluster-responses-and-predictors-to-repetitive-transcranial-magnetic-stimulation-treatment-in-parkinsons-disease%ef%bc%9aa-retrospective-study/