Frontiers in Aging Neuroscience (Jan 2024)
High-frequency rTMS over bilateral primary motor cortex improves freezing of gait and emotion regulation in patients with Parkinson’s disease: a randomized controlled trial
- Wenjing Song,
- Wenjing Song,
- Wenjing Song,
- Zixuan Zhang,
- Zixuan Zhang,
- Bingchen Lv,
- Bingchen Lv,
- Jinyu Li,
- Jinyu Li,
- Hao Chen,
- Hao Chen,
- Shenyang Zhang,
- Shenyang Zhang,
- Jie Zu,
- Jie Zu,
- Liguo Dong,
- Liguo Dong,
- Chuanying Xu,
- Chuanying Xu,
- Manli Zhou,
- Manli Zhou,
- Tao Zhang,
- Tao Zhang,
- Ran Xu,
- Ran Xu,
- Jienan Zhu,
- Jienan Zhu,
- Tong Shen,
- Tong Shen,
- Su Zhou,
- Su Zhou,
- Chenchen Cui,
- Shuming Huang,
- Xi Wang,
- Xi Wang,
- Yujing Nie,
- Kainat Aftab,
- Kainat Aftab,
- Qihua Xiao,
- Xueling Zhang,
- Guiyun Cui,
- Guiyun Cui,
- Guiyun Cui,
- Wei Zhang,
- Wei Zhang,
- Wei Zhang
Affiliations
- Wenjing Song
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Wenjing Song
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Wenjing Song
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
- Zixuan Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Zixuan Zhang
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Bingchen Lv
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Bingchen Lv
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jinyu Li
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jinyu Li
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Hao Chen
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Hao Chen
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Shenyang Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Shenyang Zhang
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jie Zu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jie Zu
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Liguo Dong
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Liguo Dong
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Chuanying Xu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Chuanying Xu
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Manli Zhou
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Manli Zhou
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Tao Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Tao Zhang
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Ran Xu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Ran Xu
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jienan Zhu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jienan Zhu
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Tong Shen
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Tong Shen
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Su Zhou
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Su Zhou
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Chenchen Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Shuming Huang
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Xi Wang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Xi Wang
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Yujing Nie
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Kainat Aftab
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Kainat Aftab
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Qihua Xiao
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Xueling Zhang
- Department of Neurology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu, China
- Guiyun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Guiyun Cui
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Guiyun Cui
- Department of Neurology, Suining County People’s Hospital, Xuzhou, Jiangsu, China
- Wei Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Wei Zhang
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Wei Zhang
- Department of Neurology, Suining County People’s Hospital, Xuzhou, Jiangsu, China
- DOI
- https://doi.org/10.3389/fnagi.2024.1354455
- Journal volume & issue
-
Vol. 16
Abstract
BackgroundFreezing of gait (FOG) is a common and disabling phenomenon in patients with Parkinson’s disease (PD), but effective treatment approach remains inconclusive. Dysfunctional emotional factors play a key role in FOG. Since primary motor cortex (M1) connects with prefrontal areas via the frontal longitudinal system, where are responsible for emotional regulation, we hypothesized M1 may be a potential neuromodulation target for FOG therapy. The purpose of this study is to explore whether high-frequency rTMS over bilateral M1 could relieve FOG and emotional dysregulation in patients with PD.MethodsThis study is a single-center, randomized double-blind clinical trial. Forty-eight patients with PD and FOG from the Affiliated Hospital of Xuzhou Medical University were randomly assigned to receive 10 sessions of either active (N = 24) or sham (N = 24) 10 Hz rTMS over the bilateral M1. Patients were evaluated at baseline (T0), after the last session of treatment (T1) and 30 days after the last session (T2). The primary outcomes were Freezing of Gait Questionnaire (FOGQ) scores, with Timed Up and Go Test (TUG) time, Standing-Start 180° Turn (SS-180) time, SS-180 steps, United Parkinson Disease Rating Scales (UPDRS) III, Hamilton Depression scale (HAMD)-24 and Hamilton Anxiety scale (HAMA)-14 as secondary outcomes.ResultsTwo patients in each group dropped out at T2 and no serious adverse events were reported by any subject. Two-way repeated ANOVAs revealed significant group × time interactions in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14. Post-hoc analyses showed that compared to T0, the active group exhibited remarkable improvements in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14 at T1 and T2. No significant improvement was found in the sham group. The Spearman correlation analysis revealed a significantly positive association between the changes in HAMD-24 and HAMA-14 scores and FOGQ scores at T1.ConclusionHigh-frequency rTMS over bilateral M1 can improve FOG and reduce depression and anxiety in patients with PD.
Keywords
- transcranial magnetic stimulation
- primary motor cortex
- freezing of gait
- emotion regulation
- Parkinson’s disease
