Use of excitatory deep repetitive transcranial magnetic stimulation with the H-coil to improve motor planning in Parkinson's disease: evidence from sensorimotor rhythms event-related desynchronization

Introduction: Our aim is to assess the efficacy of different types of navigated repetitive transcranial magnetic stimulation (rTMS) in modulating lower limb spasticity. Methods: 15 patients (10 males, 5 females, mean age 46±8.6 years) with secondary progressive multiple sclerosis and lower spastic paraparesis received 10 sessions rTMS over the motor hotspot of the tibialis anterior muscle in the primary motor соrtex with 80% of motor threshold (ten patients underwent intermittent theta burst stimulation (iTBS) (frequency 30 Hz, burst frequency 5 Hz, number of pulses 3, number of bursts 10, total number of pulses 30), 5 patients high-frequency rTMS (10 Hz)). We assessed Modified Ashworth Scale (MAS), Modified Fatique Impact Scale 2 (MFIS 2), Expanded disability status scale (EDSS), Kurtzke Functional Systems Score (FSS) and Spasticity Subjective Evaluation Scale (SSES), before and at the end of rTMS session, 2 and 12 weeks after. Results: Both iTBS and high-frequency rTMS sessions significantly reduced MAS (3.0 [3.0; 3.0] before; 2.0 [1.0; 2.0] after; p=0.01); MFIS 2 and SSES scores. We haven’t defined any significant difference between our groups. These effects were persisting for 2 weeks after the end of the stimulation protocol in all patients and remained at the same level in a half of them in 3 months. Conclusions: Our results indicate evident efficacy of both types of rTMS in treatment of severe spasticity. We currently move forward and include more patients with spasticity caused by variable range of disorders. Disclosure: Nothing to disclose EP2217