Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Entacapone-Levodopa-Carbidopa on Motor and Non-motor Symptoms in Parkinson's Disease: a Randomized Controlled Trial
Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Entacapone-Levodopa-Carbidopa on Motor and Non-motor Symptoms in Parkinson's Disease: a Randomized Controlled Trial
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Original abstract
Background Parkinson's disease (PD) is one of the most common movement disorders, primarily affecting middle-aged and elderly individuals. With the increasing aging population, the incidence of PD is rising, placing a heavy burden on patients' families and society. Objective To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with entacapone-levodopa-carbidopa (LCE) on motor and non-motor symptoms in PD patients. Methods The study employed a randomized, double-blind design. A total of 110 PD patients who visited the Nanjing Drum Tower Hospital Group Suqian Hospital from August 2022 to May 2024 were selected and randomly divided into a control group (n=32) , a LCE group (n=40) , and an observation group (n=38) . The control group received Madopar treatment (0.5 tablet per dose, 3 doses per day) and sham stimulation, the LCE group received LCE treatment (1 tablet per dose, 3 doses per day) and sham stimulation, and the observation group received LCE (1 tablet per dose, 3 doses per day) combined with rTMS treatment (40 sequences per day, once daily, 5 times per week) for 4 weeks. The Unified Parkinson's Disease Rating Scale PartⅢ (UPDRSⅢ) , Hamilton Depression Rating Scale (HAMD) , Hamilton Anxiety Rating Scale (HAMA) , Parkinson's Disease Sleep Scale (PDSS) , Mini-Mental State Examination (MMSE) , Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT) , and Activities of Daily Living (ADL) were used to assess improvements in motor and non-motor symptoms before and after treatment. Results In the control group, UPDRSⅢ scores decreased and ADL scores increased after treatment compared to pre-treatment (P<0.05) . In the LCE and observation groups, UPDRSⅢ, HAMD, HAMA, and SCOPA-AUT scores decreased, while MMSE, PDSS, and ADL scores increased after treatment compared to pre-treatment (P<0.05) . Post-treatment UPDRSⅢ, HAMD, HAMA, and SCOPA-AUT scores were lower, and PDSS, MMSE, and ADL scores were higher in the LCE and observation groups compared to the control group (P<0.05) . The observation group had lower UPDRSⅢ, HAMD, HAMA, and SCOPA-AUT scores and higher PDSS, MMSE, and ADL scores than the LCE group after treatment (P<0.05) . There was no significant difference in the total incidence of adverse reactions among the three groups after treatment (P>0.05) . Conclusion Treatment with rTMS combined with LCE can significantly improve motor and non-motor symptoms in PD patients, with better efficacy than monotherapy.