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Tamara

Repetitive Transcranial Magnetic Stimulation (rTMS) Therapy in Parkinson Disease: A Meta-Analysis.

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Tamara    1

 

Hi! Has anybody tried TMS? How do you feel it?

just find this article 

 

 

Abstract

OBJECTIVE: 

Several studies have reported repetitive transcranial magnetic stimulation (rTMS) therapy as an effective treatment for the control of motor symptoms in Parkinson disease. The objective of the study is to quantify the overall efficacy of this treatment.

TYPES: 

Systematic review and meta-analysis.

LITERATURE SURVEY: 

We reviewed the literature on clinical rTMS trials in Parkinson disease since the technique was introduced in 1980. We used the following databases: MEDLINE, Web of Science, Cochrane, and CINAHL

PATIENTS AND SETTING: 

Patients with Parkinson disease who were participating in prospective clinical trials that included an active arm and a control arm and change in motor scores on Unified Parkinson's Disease Rating Scale as the primary outcome. We pooled data from 21 studies that met these criteria. We then analyzed separately the effects of low- and high-frequency rTMS on clinical motor improvements.

SYNTHESIS: 

The overall pooled mean difference between treatment and control groups in the Unified Parkinson's Disease Rating Scale motor score was significant (4.0 points, 95% confidence interval, 1.5, 6.7; P = .005). rTMS therapy was effective when low-frequency stimulation (≤ 1 Hz) was used with a pooled mean difference of 3.3 points (95% confidence interval 1.6, 5.0; P = .005). There was a trend for significance when high-frequency stimulation (≥ 5 Hz) studies were evaluated with a pooled mean difference of 3.9 points (95% confidence interval, -0.7, 8.5; P = .08). rTMS therapy demonstrated benefits at short-term follow-up (immediately after a treatment protocol) with a pooled mean difference of 3.4 points (95% confidence interval, 0.3, 6.6; P = .03) as well as at long-term follow-up (average follow-up 6 weeks) with mean difference of 4.1 points (95% confidence interval, -0.15, 8.4; P = .05). There were insufficient data to statistically analyze the effects of rTMS when we specifically examined bradykinesia, gait, and levodopa-induced dyskinesia using quantitative methods.

CONCLUSION: 

rTMS therapy in patients with Parkinson disease results in mild-to-moderate motor improvements and has the potential to be used as an adjunct therapy for the treatment of Parkinson disease. Future large, sample studies should be designed to isolate the specific clinical features of Parkinson disease that respond well to rTMS therapy.

Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

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MurrayPD2    219

I participated in a study.   It seemed to provide some benefit.  Especially combined with some aerobic exercise.   I really noticed a difference then.

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otolorin    30

If this really worked on motor symptoms,why is it not being widely recommended?Did the FDA approve it?

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MurrayPD2    219

I don't know... Speculation I guess? It is not a drug and medications are the big money pushers and have the money to advertise. I see their reps going to their offices and providing them samples to hand out. 

My daughter's neurologist recommended this therapy for her epilepsy.  So, I think some doctors are willing to try it, but maybe the awareness is just not getting out there.

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stump    466
On 5/2/2017 at 4:25 PM, otolorin said:

If this really worked on motor symptoms,why is it not being widely recommended?Did the FDA approve it?

I haven't read the research papers, but before the FDA will approve anything it has to go through a lengthy and expen$ive process.  Part of that is doing proper controlled experiments.  If they did those, and the experimental group did no better than the control group, even if it's a safe procedure, it won't get approval.  If they haven't done those tests, then until they do it won't get approval.

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