Differential symptom cluster responses and predictors to repetitive transcranial magnetic stimulation treatment in Parkinson's disease: A retrospective study
Jinmei Sun,
Fengbo Xing,
Jingjing Feng,
Xin Chen,
Lingling Lv,
Xiaoqing Yao,
Mengqi Wang,
Ziye Zhao,
Qian Zhou,
Tingting Liu,
Yuqian Zhan,
Gong-Jun JI,
Kai Wang,
Panpan Hu
Affiliations
Jinmei Sun
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Fengbo Xing
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Jingjing Feng
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Xin Chen
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Lingling Lv
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Xiaoqing Yao
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Mengqi Wang
School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Ziye Zhao
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Qian Zhou
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Tingting Liu
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Yuqian Zhan
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China
Gong-Jun JI
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China; Anhui Institute of Translational Medicine, Hefei, 230000, China; Corresponding author. School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230000, China.
Kai Wang
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China; Anhui Institute of Translational Medicine, Hefei, 230000, China; Corresponding author. Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230000, China.
Panpan Hu
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230000, China; School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China; Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, 230000, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China; Anhui Institute of Translational Medicine, Hefei, 230000, China; Corresponding author. Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230000, China.
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. This study aimed to investigate the factors related to the response to rTMS in PD patients. Methods: We retrospectively analyzed the response of 70 idiopathic PD patients who underwent rTMS for 14 consecutive days targeting the supplementary motor area (SMA) in either 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). Based on previous studies, the UPDRSIII were divided into six symptom clusters: axial dysfunction, resting tremor, rigidity, bradykinesia affecting right and left extremities, and postural tremor. Subsequently, the efficacy of rTMS to different motor symptom clusters and clinical predictors were analyzed in these two trails. Results: After 14 days of treatment, only the total UPDRSIII scores and rigidity scores improved in both the open-label trial and the RCT. The results of multiple linear regression analysis indicated that 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 identified as an independent factor to predict the improvement of rigidity. Conclusion: This study demonstrated significant improvements in total UPDRSIII scores and rigidity after 14-day treatment, with baseline rigidity scores and RMT identified as predictors of treatment response, underscoring the need for individualized therapy.
