Therapeutic Effect Of Low-frequency And Theta Burst RTMS On Motor Symptoms Of Parkinson's Disease

Context:Parkinson's disease is a kind of movement disorders as the main performance of the disease,The motor symptoms root in the missed degeneration neuron which will conveyor Dopamine from the substantia nigra to the striatum..Main motor symptoms of Parkinson's disease include static tremor,muscle rigidity,bradykinesia and abnormal gait posture.In the face of Parkinson's disease as a kind of neurodegenerative disease,the main current treatments are drug therapy and surgical treatment,but Using repetitive transcranial magnetic stimulation as a noninvasive adjuvant therapy is another option.International guidelines hold that high frequency stimulation on contralateral primary motor area(M1 area)is effective for patients with Parkinson's disease improving symptoms movement(Level of evidence C).The efficacy of short-term and long-term were higher than the false stimulus control group.Purpose:Assess and observe the improvements and the therapeutic action made by rTMS on patients with Parkinson's disease's symptoms movement with the third part of the score in the Unified Parkinson's disease rating scale(UPDRS).Discuss the mechanism of action and the improvement and development direction in the future by analyzing the latest research results at home and abroad.Method:24 patients will be assigned to the treatment group A or the treatment group B randomly.The patients of group A will receive the low-frequency(1Hz)with 110%AMT(Active Motor Threshold)rTMS on the supplementary motor cortex(SMA).Meanwhile,The patients of group B will receive the high-frequency(theta bust mode)with 80%AMT rTMS on Motor Cortex(M1).The stimulation of two groups of treatment time were 1 times a day,five times a week,2 weeks in a row,a total of 10 times stimulation treatment.Rate before and after treatment with the UPDRS.Results:1.For the third part of the UPDRS of the treatment group A,there were statistically significant difference the total scores,the scores of myotonia part,symptoms of axial part between before and after treatment.There were no statistic difference the scores of the tremor and bradykinesia parts between before and after treatment.For the third part of the UPDRS of the treatment group B,there were statistically significant difference the total scores,the scores of bradykinesia part,symptoms of axial parts between before and after treatment.There were no statistic difference the scores of the tremor and myotonia parts between before and after treatment.2.Between the treatment groupA and groupB,the scores of myotonia part which were done after the treatment had obvious differences,P=0.008,there were no significant difference on the rest of the project between the groups,P<0.05.Conclusion:1.Low-frequency and theta burst TMS has a certain improvement effect on motor symptoms for Parkinson patients,but the effect is limited,there is no significant clinical effect in this study.2.In group A(the low-frequency rTMS on SMA),It has relatively obvious help to the axial symptoms and myotonia of the patients,has no definite curative effect on the resting tremor and bradykinesia for patients with Parkinson's disease yet.Meanwhile in group B(high-frequency theta bust mode rTMS on Ml),It has a partial help to bradykinesia of the patients,has no effect on the axial symptoms.the resting tremor and myotonia for patients with Parkinson's disease yet.