Repetitive transcranial magnetic stimulation in spinocerebellar ataxia : A pilot randomized controlled trial
Manor, B. (Hinda and Arthur Marcus Institute for Aging Research. Hebrew SeniorLife)
Greenstein, P. E. (Harvard Medical School)
Davila-Perez, P. (Harvard Medical School)
Wakefield, S. (Harvard Medical School)
Zhou, J. (Hinda and Arthur Marcus Institute for Aging Research. Hebrew SeniorLife)
Pascual Leone, Álvaro (Institut Germans Trias i Pujol. Institut Guttmann)
Universitat Autònoma de Barcelona

Fecha:	2019
Resumen:	Spinocerebellar ataxia (SCA) is a neurodegenerative disorder caused by dysfunction of the cerebellum and its connected neural networks. There is currently no cure for SCA and symptomatic treatment remains limited. We aimed here to examine the effects of a repetitive transcranial magnetic stimulation (rTMS) targeting the cerebellum on clinical impression, postural control and gait in patients with SCA. In this randomized, double-blinded and sham-controlled study, 20 individuals aged 18-75 years with SCA confirmed by genetic testing completed rTMS or sham intervention comprising 20 sessions of MRI-guided stimulation over the cerebellum. Baseline assessments included the Standard Ataxia Rating Assessment (SARA), the 9-hole peg test of manual dexterity, the Timed Up-and-Go (TUG) test, standing postural control with eyes-open and eyes-closed, and gait. Immediate (within 1-week) and 1-month follow-ups were completed. Intervention compliance was high (19 ± 2 of 20 sessions) and no rTMS-related adverse events were reported. rTMS, compared to sham, was associated with greater percent improvement in SARA total score from baseline to the 1-month follow-up (p = 0. 008). Secondary analyses of individual SARA items revealed that rTMS improved performance within the "stance" sub-score only (p = 0. 002). This functional change was accompanied by improvement to several objective metrics of postural sway during eyes-open and eyes-closed standing (p < 0. 008). rTMS did not influence the 9-hole peg test, TUG, or gait kinematics. A 20-session rTMS intervention is safe and feasible for those with SCA. Additional research is warranted to confirm the observed longer-term benefits of this intervention on standing postural control.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Standard Ataxia Rating Assessment ; Cerebellum ; RTMS ; Spinocerebellar ataxia ; Standing postural control
Publicado en:	Frontiers in neurology, Vol. 10 Núm. FEB (2019) , p. 73, ISSN 1664-2295

DOI: 10.3389/fneur.2019.00073
PMID: 30809184

8 p, 930.0 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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