Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Study Design
2.3. Clinical Assessment
2.4. 3D-Gait Analysis
2.5. Repetitive Transcranial Magnetic Stimulation
2.6. Statistics
3. Results
3.1. Selection of Gait Parameters
3.2. Impact of iTBS on Gait
3.2.1. Walking without Obstacles (P-I)
3.2.2. Passing through Narrow Space (P-II)
3.2.3. Turning towards the Side More Affected by PD (P-III)
3.2.4. Turning Away from the Side More Affected by PD (P-IV)
3.2.5. Overall Motor Performance
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
Appendix A
References
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Number of Participants | 12 |
---|---|
Age (years) | 64.30 (52.8–68.3) |
Sex (male / female) | 10/2 |
Disease duration (years) | 12.5 (10.5–15.0) |
Hoehn and Yahr | 2.0 (2.0–2.8) |
UPDRS I | 3.0 (0.5–4.0) |
UPDRS II | 16.5 (10.3–20.8) |
UPDRS III (OFF) (blinded) | 30.0 (25.3–33.8) |
UPDRS III (OFF) (unblinded, incl. rigidity item) | 37.0 (31.0–43.8) |
FOG-Q | 10.5 (10.0–11.8) |
FOG duration (years since symptom onset) | 3.0 (1.0–8.0) |
Visit with Sham Stimulation | Visit with Real iTBS | p-Value | |
---|---|---|---|
Hemisphere contralateral to the clinically more affected side | |||
RMT | 86.25 ± 9.78 | 87.50 ± 11.51 | 0.78 |
AMT | 73.67 ± 6.17 | 73.00 ± 8.56 | 0.83 |
Hemisphere contralateral to the clinically less affected side | |||
RMT | 83.92 ± 15.24 | 82.67 ± 14.46 | 0.84 |
AMT | 70.33 ± 10.45 | 70.25 ± 10.37 | 0.99 |
Gait Parameters | Walking without Obstacles | Passing through Narrow Spaces | Turning towards More Affected Side | Turning towards Less Affected Side | p-Value |
---|---|---|---|---|---|
more affected side | |||||
stride time (s) | 1.01 ± 0.06 | 1.06 ± 0.10 | 0.99 ± 0.21 | 1.02 ± 0.14 | 0.007 |
stride length (m) | 1.13 ± 0.18 | 1.07 ± 0.18 | 0.38 ± 0.14 | 0.40 ± 0.15 | <0.001 |
DLST (%) | 30.04 ± 4.48 | 31.44 ± 5.24 | 41.16 ± 7.22 | 38.97 ± 6.47 | <0.001 |
walking speed (m/s) | 1.13 ± 0.20 | 1.02 ± 0.21 | 0.38 ± 0.11 | 0.39 ± 0.14 | <0.001 |
less affected side | |||||
stride time (s) | 1.01 ± 0.06 | 1.06 ± 0.10 | 0.99 ± 0.22 | 1.01 ± 0.12 | 0.017 |
stride length (m) | 1.13 ± 0.18 | 1.07 ± 0.18 | 0.38 ± 0.16 | 0.39 ± 0.10 | <0.001 |
DLST (%) | 30.17 ± 4.39 | 31.49 ± 4.96 | 41.98 ± 7.56 | 39.26 ± 7.06 | <0.001 |
walking speed (m/s) | 1.12 ± 0.20 | 1.01 ± 0.21 | 0.38 ± 0.15 | 0.39 ± 0.10 | <0.001 |
both legs | |||||
gait asymmetry (%) | 4.61 ± 5.20 | 5.85 ± 6.46 | 15.93 ± 11.40 | 15.53 ± 13.96 | <0.001 |
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Brugger, F.; Wegener, R.; Baty, F.; Walch, J.; Krüger, M.T.; Hägele-Link, S.; Bohlhalter, S.; Kägi, G. Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait. Brain Sci. 2021, 11, 321. https://doi.org/10.3390/brainsci11030321
Brugger F, Wegener R, Baty F, Walch J, Krüger MT, Hägele-Link S, Bohlhalter S, Kägi G. Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait. Brain Sciences. 2021; 11(3):321. https://doi.org/10.3390/brainsci11030321
Chicago/Turabian StyleBrugger, Florian, Regina Wegener, Florent Baty, Julia Walch, Marie T. Krüger, Stefan Hägele-Link, Stephan Bohlhalter, and Georg Kägi. 2021. "Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait" Brain Sciences 11, no. 3: 321. https://doi.org/10.3390/brainsci11030321