Cerebellar repetitive transcranial magnetic stimulation (rTMS) for essential tremor: A double-blind, sham-controlled, crossover, add-on clinical trial
Background: There is controversial evidence about the effect of cerebellar low-frequency stimulation in patients with essential tremor (ET). Objectives: In this study we assessed safety and effectiveness of 1 Hz (low-frequency) cerebellar repetitive transcranial magnetic stimulation (rTMS) on tremor...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | Brain Stimulation |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1935861X19304103 |
| _version_ | 1818737528153309184 |
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| author | Nahid Olfati Ali Shoeibi Ebrahim Abdollahian Hamideh Ahmadi Alireza Hoseini Saeed Akhlaghi Vida Vakili Mohsen Foroughipour Fariborz Rezaeitalab Mohammad-Taghi Farzadfard Parvaneh Layegh Shahrokh Naseri |
| author_facet | Nahid Olfati Ali Shoeibi Ebrahim Abdollahian Hamideh Ahmadi Alireza Hoseini Saeed Akhlaghi Vida Vakili Mohsen Foroughipour Fariborz Rezaeitalab Mohammad-Taghi Farzadfard Parvaneh Layegh Shahrokh Naseri |
| author_sort | Nahid Olfati |
| collection | DOAJ |
| description | Background: There is controversial evidence about the effect of cerebellar low-frequency stimulation in patients with essential tremor (ET). Objectives: In this study we assessed safety and effectiveness of 1 Hz (low-frequency) cerebellar repetitive transcranial magnetic stimulation (rTMS) on tremor severity in patients with essential tremor in a sham-controlled crossover trial. Methods: A total of 23 patients assigned into two groups to receive either sham (n = 10) or rTMS (n = 13) treatment, with crossing over after a two-month washout period. Intervention consisted of 900 pulses of 1 Hz rTMS at 90% resting motor threshold or the same protocol of sham stimulation over each cerebellar hemisphere for 5 consecutive days. Tremor severity was assessed by Fahn-Tolosa-Marin (FTM) scale at baseline and at days 5, 12 and 30 after intervention. The FTM consists of 3 subscales including tremor severity rating, performance of motor tasks, and functional disability. Carry-over and treatment effects were analyzed using independent samples t-test. Results: There was no significant improvement in the total FTM scores in rTMS compared to the sham stimulation on day 5 (p = 0.132), day 12 (p = 0.574), or day 30 (p = 0.382). Similarly, FTM subscales, including tremor severity rating, motor tasks, and functional disability did not improve significantly after rTMS treatment. Mild headache and local pain were the most frequent adverse events. Conclusion: Although cerebellar rTMS seems to have acceptable safety when used in ET patients, this study could not prove any efficacy for it in reduction of tremor in these patients. Larger studies are needed to evaluate efficacy of this therapeutic intervention and to provide evidence about the optimal stimulation parameters. |
| first_indexed | 2024-12-18T00:54:28Z |
| format | Article |
| id | doaj.art-2b56357d8102425683f8e125bf6b088f |
| institution | Directory Open Access Journal |
| issn | 1935-861X |
| language | English |
| last_indexed | 2024-12-18T00:54:28Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain Stimulation |
| spelling | doaj.art-2b56357d8102425683f8e125bf6b088f2022-12-21T21:26:34ZengElsevierBrain Stimulation1935-861X2020-01-01131190196Cerebellar repetitive transcranial magnetic stimulation (rTMS) for essential tremor: A double-blind, sham-controlled, crossover, add-on clinical trialNahid Olfati0Ali Shoeibi1Ebrahim Abdollahian2Hamideh Ahmadi3Alireza Hoseini4Saeed Akhlaghi5Vida Vakili6Mohsen Foroughipour7Fariborz Rezaeitalab8Mohammad-Taghi Farzadfard9Parvaneh Layegh10Shahrokh Naseri11Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, IranDepartment of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, Iran; Corresponding author. Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Ahmad-Abad st., 91766-99199, Mashhad, Khorasan-e-Razavi, Iran.Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Psychiatry and Behavioral Sciences Research Center, Ibn-Sina Medical Center, Mashhad, IranDepartment of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, IranFaculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Psychiatry and Behavioral Sciences Research Center, Ibn-Sina Medical Center, Mashhad, IranDepartment of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, IranDepartment of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, IranDepartment of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, IranDepartment of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Quaem Medical Center, Mashhad, IranDepartment of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranBackground: There is controversial evidence about the effect of cerebellar low-frequency stimulation in patients with essential tremor (ET). Objectives: In this study we assessed safety and effectiveness of 1 Hz (low-frequency) cerebellar repetitive transcranial magnetic stimulation (rTMS) on tremor severity in patients with essential tremor in a sham-controlled crossover trial. Methods: A total of 23 patients assigned into two groups to receive either sham (n = 10) or rTMS (n = 13) treatment, with crossing over after a two-month washout period. Intervention consisted of 900 pulses of 1 Hz rTMS at 90% resting motor threshold or the same protocol of sham stimulation over each cerebellar hemisphere for 5 consecutive days. Tremor severity was assessed by Fahn-Tolosa-Marin (FTM) scale at baseline and at days 5, 12 and 30 after intervention. The FTM consists of 3 subscales including tremor severity rating, performance of motor tasks, and functional disability. Carry-over and treatment effects were analyzed using independent samples t-test. Results: There was no significant improvement in the total FTM scores in rTMS compared to the sham stimulation on day 5 (p = 0.132), day 12 (p = 0.574), or day 30 (p = 0.382). Similarly, FTM subscales, including tremor severity rating, motor tasks, and functional disability did not improve significantly after rTMS treatment. Mild headache and local pain were the most frequent adverse events. Conclusion: Although cerebellar rTMS seems to have acceptable safety when used in ET patients, this study could not prove any efficacy for it in reduction of tremor in these patients. Larger studies are needed to evaluate efficacy of this therapeutic intervention and to provide evidence about the optimal stimulation parameters.http://www.sciencedirect.com/science/article/pii/S1935861X19304103Essential tremorCerebellumNon-invasive brain stimulationClinical trialTranscranial magnetic stimulationrTMS |
| spellingShingle | Nahid Olfati Ali Shoeibi Ebrahim Abdollahian Hamideh Ahmadi Alireza Hoseini Saeed Akhlaghi Vida Vakili Mohsen Foroughipour Fariborz Rezaeitalab Mohammad-Taghi Farzadfard Parvaneh Layegh Shahrokh Naseri Cerebellar repetitive transcranial magnetic stimulation (rTMS) for essential tremor: A double-blind, sham-controlled, crossover, add-on clinical trial Brain Stimulation Essential tremor Cerebellum Non-invasive brain stimulation Clinical trial Transcranial magnetic stimulation rTMS |
| title | Cerebellar repetitive transcranial magnetic stimulation (rTMS) for essential tremor: A double-blind, sham-controlled, crossover, add-on clinical trial |
| title_full | Cerebellar repetitive transcranial magnetic stimulation (rTMS) for essential tremor: A double-blind, sham-controlled, crossover, add-on clinical trial |
| title_fullStr | Cerebellar repetitive transcranial magnetic stimulation (rTMS) for essential tremor: A double-blind, sham-controlled, crossover, add-on clinical trial |
| title_full_unstemmed | Cerebellar repetitive transcranial magnetic stimulation (rTMS) for essential tremor: A double-blind, sham-controlled, crossover, add-on clinical trial |
| title_short | Cerebellar repetitive transcranial magnetic stimulation (rTMS) for essential tremor: A double-blind, sham-controlled, crossover, add-on clinical trial |
| title_sort | cerebellar repetitive transcranial magnetic stimulation rtms for essential tremor a double blind sham controlled crossover add on clinical trial |
| topic | Essential tremor Cerebellum Non-invasive brain stimulation Clinical trial Transcranial magnetic stimulation rTMS |
| url | http://www.sciencedirect.com/science/article/pii/S1935861X19304103 |
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