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Cerebellar rTMS for motor control in progressive supranuclear palsy

M L Dale¹, W H DeVries², M Mancini³

¹Murray Center for Research on Parkinson's & Related Disorders, Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.

Brain Stimulation

|August 6, 2019

Abstract

Background:

Stimulatory cerebellar TMS is a promising tool to improve motor control in neurodegenerative disorders.

Objective/Hypothesis:

Our goal was to use 10Hz cerebellar rTMS to augment cerebellar-brain inhibition (CBI) for improved postural stability and speech in patients with progressive supranuclear palsy (PSP).

Methods:

We performed CBI assessments with neuronavigation before and after high frequency cerebellar rTMS or sham TMS in two patients with PSP, using a double cone coil for the conditioning pulse and a figure-of-eight coil for the test pulse and treatments. We collected posturography data and speech samples before and after treatment.

Results:

After treatment, CBI increased by 50% in subject 1 and by 32% in subject 2, and postural stability and speech improved. The protocol was well tolerated, but the sham was not consistently believable.

Conclusion:

Cerebellar rTMS may improve postural stability and speech in PSP, but cooled coils with vibrotactile sham capability are needed for larger future studies.

Keywords:

Balance Cerebellum Posturography Progressive supranuclear palsy Speech Transcranial magnetic stimulation

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