Repetitive transcranial magnetic stimulation can improve anxiety in Parkinson’s disease: a randomized, double-blind, sham-controlled study

High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) applied to the left dorsolateral prefrontal cortex (DLPFC) has been shown to improve depression in Parkinson’s disease (PD). However, there is limited clinical evidence available regarding its effectiveness in treating anxiety. Methods: Thirty patients with PD and mild to moderate anxiety were randomly assigned to active (n=15) and sham (n=15) rTMS treatment groups. HF-rTMS was administered to the left DLPFC for 10 consecutive days. A blinded investigator conducted three videotaped evaluations on each patient: before stimulation (baseline), 1 day (short-term effect), and 30 days after treatment cessation (long-term effect). The Hamilton Anxiety Scale (HAM-A) was used to evaluate the alterations in anxiety, which served as the primary endpoint of the study. Results: Data from two patients, one from the active group and another from the sham-treated group, were not considered for analysis, as they did not complete the protocol. In the active treatment group, the severity of anxiety improved from 14.9 ± 4.8 points to 8.3 ± 5.2 points (p=0.039), while in the sham-treated group, it remained unchanged (from 14.5 ± 5.7 points to 14.1 ± 5.2 points, p=0.879). Conclusions: Our results indicate that HF-rTMS applied to the left DLPFC has beneficial effects in treating anxiety among PD patients.