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Cerebellar rTMS for motor control in progressive supranuclear palsy

  • Author Footnotes
    1 67 President Street, Suite 502-N, MSC 861, Charleston, SC 29425.
    ,
    Author Footnotes
    2 3181 SW Sam Jackson Park Road, Portland, OR 97239.
    M.L. Dale
    Correspondence
    Corresponding author. 3181 S.W. Sam Jackson Park Rd. Mail Code: OP32, Portland, OR, 97239, USA
    Footnotes
    1 67 President Street, Suite 502-N, MSC 861, Charleston, SC 29425.
    2 3181 SW Sam Jackson Park Road, Portland, OR 97239.
    Affiliations
    Murray Center for Research on Parkinson's & Related Disorders, Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
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  • W.H. DeVries
    Affiliations
    Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
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  • M. Mancini
    Affiliations
    Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, Portland, OR, USA
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  • M.S. George
    Affiliations
    Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
    Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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  • Author Footnotes
    1 67 President Street, Suite 502-N, MSC 861, Charleston, SC 29425.
    2 3181 SW Sam Jackson Park Road, Portland, OR 97239.

      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

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