Efficacy observation of low frequency repetitive transcranial magnetic stimulation treating autonomic dysfunction in Parkinson disease

Hu Xiaohui; Chen Guoyan; Xu Ping; Lei Gesheng; Su Changjun

doi:10.3760/cma.j.issn.1673-4777.2017.02.018

Abstract：Objective To observe the clinical effect of low frequency repetitive transcranial magnetic stimulation (rTMS) on autonomic dysfunction in patients with Parkinson disease.Methods A total of 52 patients diagnosed of Parkinson disease from May 2014 to September 2015 in Tangdu Hospital of the Fourth Military Medical University were randomly divided into rTMS group and control group,with 26 cases in each group.The rTMS group had low frequency rTMS + Levodopa and Benserazide tablets (0.25 g/time,3 times/d,oral);the control group had Pseudo-coil rTMS + Levodopa and Benserazide tablets (the same for rTMS group);the treatments were given 1 time/d,20 minutes/time for 10 d,the 2 groups continued to take Levodopa and Benserazide tablets treatment.The Scale Outcomes in Parkinson Disease for Autonomic Symptoms (SCOPA-AUT) and Unified Parkinson Disease Rating Scale (UPDRS) were compared between 2 groups before and after treatment.Results SCOPA-AUT and UPDRS scores had no significant differences between groups before treatment(P ＞ 0.05).SCOPA-AUT and UPDRS scores had no significant differences among different mearsuring time points in control group after treatment (P ＞ 0.05).SCOPA-AUT and UPDRS scores on the 30th,90th and 180th day after treatment start were significantly lower than those before treatment in rTMS group [SCOPA-AUT:(13.5 ± 2.1),(12.6 ± 2.2),(15.3 ± 2.9) scores vs (22.7 ± 2.7) scores;UPDRS:(40 ± 9),(21 ± 8),(32 ± 8) scores vs (64 ± 11) scores] (all P ＜ 0.05).SCOPA-AUT and UPDRS scores at the 90th day after treatment in rTMS group were significantly lower than those in control group [(12.6 ± 2.2) scores vs (18.9±1.7)scores,(21±8)scores vs(43±9)scores](P＜0.01).Conclusion Low frequency rTMSis effective for treating autonomic dysfunction in Parkinson disease;the mid-term efficacy is better than short-term and long-term results.