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Acta Neurol Belg. 2016 Jun;116(2):145-50. doi: 10.1007/s13760-015-0540-y. Epub 2015 Sep 10.

Motor cortex rTMS improves dexterity in relapsing-remitting and secondary progressive multiple sclerosis.

Author information

1
Clinical Neurophysiology Unit, Cairo University Hospitals, Kasr Alainy St., Cairo, 11562, Egypt.
2
Clinical Neurophysiology Unit, Cairo University Hospitals, Kasr Alainy St., Cairo, 11562, Egypt. lafifi2@kasralainy.edu.eg.
3
Neurology Department, Cairo University Hospitals, Cairo, Egypt.

Abstract

The motor cortex (MC) receives an excitatory input from the cerebellum which is reduced in patients with cerebellar lesions. High-frequency repetitive transcranial magnetic stimulation (rTMS) induces cortical facilitation which can counteract the reduced cerebellar drive to the MC. Our study included 24 relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS) patients with dysmetria. The patients were divided into two groups: Group A received two sessions of real MC rTMS and Group B received one session of real rTMS and one session of sham rTMS. Ten healthy volunteers formed group C. Evaluation was carried out using the nine-hole pegboard task and the cerebellar functional system score (FSS) of the expanded disability status scale (EDSS). Group A patients showed a significant improvement in the time required to finish the pegboard task (P = 0.002) and in their cerebellar FSS (P = 0.000) directly after the second session and 1 month later. The RRMS patients showed more improvement than the SPMS patients. Group B patients did not show any improvement in the pegboard task or the cerebellar FSS. These results indicate that MC rTMS can be a promising option in treating both RRMS or SPMS patients with cerebellar impairment and that its effect can be long-lasting.

KEYWORDS:

Cerebellum; Dysmetria; Motor cortex; Multiple sclerosis; Repetitive transcranial magnetic stimulation; rTMS

PMID:
26358951
DOI:
10.1007/s13760-015-0540-y
[Indexed for MEDLINE]

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