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Effect of cerebellar vermis intermittent theta-burst stimulation on balance function in frail older adults: a
Xin Tian1, Neng Huang1, Yuan Shi2
1Department of Rehabilitation Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, PR China.
Background:
With the increasing population of frail older adults, their compromised balance functions pose risks of falls and mortality. Effectively enhancing balance function could mitigate adverse health outcomes. This study aimed to evaluate the effect of intermittent theta-burst stimulation (iTBS) on balance function in frail older adults.
Methods:
Fourty-eight subjects were randomly assigned to receive iTBS and sham stimulation in a randomized control trial design over a period of 4 weeks. Before and after intervention, related balance evaluation data was collected, including berg balance scale (BBS) score, Time-up and go (TUG) test, Sensory Organization Test (SOT) and Limit of Stability (LOS) data obtained through the Balance Master system. Additionally, cortical activity was recorded using functional near-infrared spectroscopy (fNIRS), fNIRS was used as an exploratory neuroimaging measure. The Tilburg Frailty Indicator (TFI) was also assessed.
Results:
A total of 45 subjects (mean [SD] age, 67.69 [8.16] years; 33 females [73.7%]) completed the trial were enrolled and randomized to receive iTBS (n = 23) or sham stimulation (n = 22). After intervention, the BBS (p<0.001), and TFI (p<0.001) score statistically significant improved in the iTBS group. The SOT (p<0.05) also improved. And the LOS had statistically significant improvement. However, no statistically significant difference was found in the Timed Up and Go (TUG) test between the two groups (p > 0.05). And study showed a significant difference in HbO levels for the left DLPFC (p < 0.05; 95% CI: -0.066, -0.003) and bilateral SMA (p<0.05, 95% CI: -0.061, -0.007; p<0.05, 95% CI: -0.072, -0.016) before and after the intervention. No significant adverse effects were reported on all subjects.
Conclusions:
Our findings indicate that iTBS could promote balance function, as evidenced by an increase in the BBS score, improvements in SOT and LOS, as well as elevated levels of oxygenated hemoglobin (HbO) in the dorsolateral prefrontal cortex (DLPFC) and supplementary motor area (SMA).
Clinical Trial Number:
This clinical study was registered at Chinese Clinical Trial Registry (ChiCTR, ChiCTR2500097468; registered on 19/02/2025).
