Repetitive transcranial magnetic stimulation for ALS. A preliminary controlled study

Area of Science:

• Neuroscience
• Neuromodulation
• Clinical Neurology

Background:

• Repetitive transcranial magnetic stimulation (rTMS) modulates brain neurotransmission.
• Continuous theta-burst stimulation (cTBS) is a novel rTMS paradigm causing prolonged motor cortex excitability suppression.

Purpose of the Study:

• To investigate the potential beneficial effects of cTBS on motor cortex excitability in amyotrophic lateral sclerosis (ALS) patients.
• To assess the safety and efficacy of cTBS as a therapeutic approach for ALS.

Main Methods:

• A double-blind, placebo-controlled trial involving twenty patients with definite ALS.
• Random allocation to blinded active or placebo cTBS over six months, with stimulation five days per month.
• Primary outcome measured by the rate of decline on the ALS Functional Rating Scale.

Main Results:

• The treatment was well-tolerated by all participants.
• Active cTBS showed a modest but significant slowing of motor function deterioration compared to placebo.
• Fifteen patients completed the 6-month study and were included in the analysis.

Conclusions:

• cTBS appears to be a safe and potentially effective neuromodulation therapy for ALS.
• Further investigation in larger patient cohorts is warranted to confirm these preliminary findings.
• This pilot study opens a new therapeutic perspective for ALS management.