Einfluss der repetitiven transkraniellen Magnetstimulation (rTMS) auf motorische Störungen bei Patienten mit Morbus Parkinson und Morbus Wilson
Einfluss der repetitiven transkraniellen Magnetstimulation (rTMS) auf motorische Störungen bei Patienten mit Morbus Parkinson und Morbus Wilson
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Original abstract
INTRODUCTION: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive stimulation technique used in clinical research and for the experimental treatment of neurological and psychiatric disorders. The aim of this study was to examine how effective rTMS is for Parkinson's disease (PD) and Wilson's disease (WD), and to ascertain whether a link exists between the motor rTMS effects and the state of the dopaminergic nigrostriatal system. METHODS: We examined 15 patients with PD (Hoehn & Yahr stage I or II) and 15 patients with WD (neurological form) with a single subthreshold 5 Hz-rTMS. The motor disturbances were evaluated using the motor section of the UPDRS, the “CS”-writing test and a handwriting sample. The dopaminergic nigrostriatal system was assessed using [ 123I]-β-CIT-, [ 123I]-FP-CIT- and [ 123I]-IBZM-SPECT. RESULTS: The patients with PD benefited significantly in the UPDRS. In the “CS”-writing test, the symptom improvement trend was less pronounced. In the handwriting sample, micrography sank from 40% to an average of 19%. Judging by the nuclear medicine findings, above all those patients with PD in whom the dopaminergic nigrostriatal system was not as pronounced profited from rTMS. Following rTMS, the patients with WD did not show significant improvement in their motor symptoms. Improvement was only observed in individual cases. DISCUSSION: We verified the effectiveness of rTMS in PD. However, in connection with WD, rTMS can only be recommended as a course of treatment in individual cases. Although exactly how rTMS works in detail is still unknown, our findings indicate that the function-enhancing effects of rTMS are linked to the dopaminergic system.