Role and potential mechanism of repetitive transcranial magnetic stimulation on depressive disorder in patients with Parkinson's disease

GUO Zixuan; XU Lina; DONG Huifang

Abstract：Objective:To investigate the effect and possible mechanism of repetitive transcranial magnetic stimula-tion(rTMS)on depressive disorder in patients with Parkinson's disease(PD).Methods:All 120 patients with PD de-pression in outpatient and inpatient departments of Jincheng People's Hospital from December 2021 to June 2023 were prospectively selected,which were randomly divided into sham stimulation group,low-frequency rTMS group(0.5 Hz)and high-frequency rTMS group(5 Hz).After continuous treatment for 2 weeks,all participants underwent ex-aminations of Hamilton Rating Scale(HAMD),the motor part of the Unified Parkinson Disease Rating Scale(UPDRS-Ⅲ)and Parkinson's disease Quality of Life questionnaire(PDQ-39)after treatment immediately and 4 weeks after treatment respectively,and the optimal treatment parameters for PD depressive disorder were obtained by statistical a-nalysis.By detection of inflammatory cytokines which was performed in the patients of optimal treatment group,we may conclude the possible mechanism of rTMS.Results:Compared with the sham stimulation group,the HAMD score,UP-DRS-Ⅲ score and PDQ-39 score of the high-frequency and low-frequency rTMS groups were decreased after treatment,and the differences were statistically significant(P＜0.05).The therapeutic effect of high-frequency rTMS group and low-frequency rTMS group was statistically different in the treatment of Parkinson's depression(P＜0.05).The serum IL-6 level in the high-frequency rTMS group decreased immediately after treatment and 4 weeks after treatment,and the differences were statistically significant(P＜0.05).Conclusion:The group of high-frequency rTMS can significantly improve the depressive symptoms of patients with PD,and the curative effect can be sustained until 4 weeks after treatment,which is mediated by reducing the serum IL-6 level of patients.