IS 29. Effect of rTMS on Freezing of Gait

Freezing of Gait (FOG) is a disabling symptom that commonly affects patients with Parkinson’s disease (PD) and current treatments are very limited. Previous studies have reported that repetitive transcranial magnetic stimulation (rTMS) can improve the motor symptoms of various neurologic diseases. In this experiment, we investigated the site-specific modulation effects of rTMS on FOG in PD. Twenty patients with PD were recruited. All participants received randomly arranged 4 sessions of rTMS with more than 24 h. of washout period between the session. In each session, 10 Hz rTMS (90% of RMT, total 1000 pulses) was applied with double cone coil over the primary motor cortex (M1) for lower limb, the supplementary motor cortex, or the dorsolateral prefrontal cortex (DLPFC) of dominant hemisphere. Sham rTMS was performed with the coil at an angle of 90 degrees from the tangential plane to the vertex using the same stimulation parameters. Unified Parkinson’s Disease Rating Scale (UPDRS), timed 6 m walk test, and SS-180° turning test were evaluated before and immediately after each rTMS session. Motor cortical excitability was also assessed. When rTMS was given over M1, significant beneficial effects on UPDRS and gait speed were observed ( p p p