Rhythmic transcranial magnetic stimulation in the treatment of cervical dystonia and comorbid mental disorders

Abstract

Cervical dystonia (CD) is a common form of movement disorder with a high incidence of comorbid mental disorders. Rhythmic transcranial magnetic stimulation (rTMS) is effective in depression and other mental disorders, but its efficacy in CD with comorbid mental disorders has been poorly studied.Objective: to investigate the efficacy of rTMS in CD and comorbid mental disorders.Material and methods. Seventeen patients with CD underwent a course of 10 rTMS sessions (protocol: 1 Hz, 600 pulses to the left primary motor cortex). The severity of mental disorders, quality of life and severity of cervical dystonia were assessed using the HADS, SF-36 and CDQ-24 scales.Results. After transcranial magnetic stimulation treatment, a significant reduction in anxiety (from 12.2±4.1 to 6.3±2.1 points; p<0.01) and depression (from 8.4±3.7 to 5.2±3.2 points; p<0.01) on the HADS scale were noted, and a significant improvement in both physical (from 37±15.2 to 45±17.3 points; p=0.017) and mental (from 31±11.2 to 38±9.6 points; p=0.008) quality of life components according to SF-36. The severity of CD according to CDQ-24 also decreased significantly (from 60.2±11.7 to 51±12.4 points; p=0.022), and there were improvements in the subscales of emotional well-being and social and family life.Conclusion. The efficacy of rTMS in reducing the severity of both manifestations of CD and comorbid mental disorders was established.

Keywords

• cervical dystonia
• transcranial magnetic stimulation
• non-drug biological therapies
• non-motor symptoms
• neuropsychiatry