Repetitive transcranial magnetic stimulation of the motor cortex ameliorates spasticity in multiple sclerosis.

Full Abstract

OBJECTIVE:
To investigate whether repetitive transcranial magnetic stimulation (rTMS) can modify spasticity.

METHODS:
We used high-frequency (5 Hz) and low-frequency (1 Hz) rTMS protocols in 19 remitting patients with relapsing-remitting multiple sclerosis and lower limb spasticity.

RESULTS:
A single session of 1 Hz rTMS over the leg primary motor cortex increased H/M amplitude ratio of the soleus H reflex, a reliable neurophysiologic measure of stretch reflex. Five hertz rTMS decreased H/M amplitude ratio of the soleus H reflex and increased corticospinal excitability. Single sessions did not induce any effect on spasticity. A significant improvement of lower limb spasticity was observed when rTMS applications were repeated during a 2-week period. Clinical improvement was long-lasting (at least 7 days after the end of treatment) when the patients underwent 5 Hz rTMS treatment during a 2-week protocol. No effect was obtained after a 2-week sham stimulation.

CONCLUSIONS:
Repetitive transcranial magnetic stimulation may improve spasticity in multiple sclerosis.

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Author information

Author/s: Centonze, D (D); Koch, G (G); Versace, V (V); Mori, F (F); Rossi, S (S); Brusa, L (L); Grossi, K (K); Torelli, F (F); Prosperetti, C (C); Cervellino, A (A); Marfia, G A (GA); Stanzione, P (P); Marciani, M G (MG); Boffa, L (L); Bernardi, G (G);

Affiliation: Clinica Neurologica, Dipartimento di Neuroscienze, Università di Tor Vergata, Rome, Italy. centonze(-atsign-)uniroma2.it

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't

Journal: Neurology (Neurology), published in United States. (Language: eng)

Reference: 2007-Mar; vol 68 (issue 13) : pp 1045-50

Dates: Created 2007/03/28; Completed 2007/04/25;

PMID: 17389310, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Female
H-Reflex - physiology
Humans
Leg - physiopathology
Male
Middle Aged
Motor Cortex - physiopathology
Multiple Sclerosis - complications; physiopathology

Multiple Sclerosis - complications; physiopathology
Muscle Contraction - physiology
Muscle Hypertonia - etiology; physiopathology; therapy
Muscle Spasticity - etiology; physiopathology; therapy
Muscle, Skeletal - innervation; physiopathology
Pyramidal Tracts - physiopathology
Reflex, Abnormal - physiology
Transcranial Magnetic Stimulation - methods
Treatment Outcome

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