1. Estimulación magnética transcraneal theta-burst intermitente para el tratamiento de la espasticidad en pacientes con esclerosis múltiple recurrente: resultados de un ensayo clínico aleatorizado doble ciego
- Author
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Ángel Salgado-Barreira, Luciana Midaglia, Sandro J Ribeiro, Susana Lion-Vázquez, Lucía Rodríguez-Sánchez, Moisés N Pereira-Martínez, D. Muñoz, Breogán Rodríguez-Acevedo, Elena Álvarez-Rodriguez, Carina Diéguez-Varela, José Miguel Ramos Fernández, Mónica Collazo-Diéguez, Arturo Fraga-Bau, and Pablo Vicente-Alba
- Subjects
business.industry ,Multiple sclerosis ,Modified Ashworth scale ,medicine.medical_treatment ,Placebo-controlled study ,General Medicine ,medicine.disease ,law.invention ,Transcranial magnetic stimulation ,medicine.anatomical_structure ,Randomized controlled trial ,law ,Anesthesia ,Medicine ,Silent period ,Neurology (clinical) ,Spasticity ,medicine.symptom ,business ,Motor cortex - Abstract
Aim. It has been suggested that the repetitive transcranial magnetic stimulation could be useful as a non-pharmacological treatment for spasticity. The aim of this study was to evaluate the clinical and neurophysiological effects of high-frequency intermittent theta burst stimulation (iTBS) on lower limb spasticity in patients with relapsing multiple sclerosis in a randomized, double-blind placebo controlled trial. Patients and methods. Seventeen patients in the remitting phase of the disease were randomly allocated to sham or magnetic therapy group and underwent iTBS over contralateral motor cortex of the most affected leg once a day for two weeks. Each session consisted of 10 bursts containing three pulses at 50 Hz repeated at 200 ms intervals (5 Hz) every 10 s for a total of 600 stimuli. The iTBS effect was assessed by using clinical (such as the Modified Ashworth Scale) and neurophysiological (H/M amplitude ratio and cortical silent period duration) parameters. Results. Two-week iTBS over motor cortex of the most affected leg did not produce any significant clinical effect on spasticity. However, it decreases the H/M amplitude ratio and increases duration of cortical silent period but not significantly, in patients with relapsing multiple sclerosis. Conclusion. The stimulation protocol used in this study does not have significant therapeutic effect. Therefore, we do recommend further studies as neurophysiological changes were evident.
- Published
- 2019
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