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Effects of intermittent theta burst stimulation on spasticity in patients with multiple sclerosis
Author(s) -
Mori F.,
Codecà C.,
Kusayanagi H.,
Monteleone F.,
Boffa L.,
Rimano A.,
Bernardi G.,
Koch G.,
Centonze D.
Publication year - 2010
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2009.02806.x
Subject(s) - spasticity , medicine , transcranial magnetic stimulation , multiple sclerosis , stimulation , modified ashworth scale , physical medicine and rehabilitation , h reflex , anesthesia , physical therapy , psychiatry
Background and purpose: Spasticity is a common disorder and a major cause of long‐term disability in patients with multiple sclerosis (MS). Our aim was to evaluate whether a recently developed repetitive transcranial magnetic stimulation protocol, the intermittent theta burst stimulation (iTBS) is effective in modulating lower limb spasticity in MS patients. Methods: Twenty MS patients were pseudorandomized to undergo a 2‐week daily sessions of real or sham iTBS protocol. The H / M amplitude ratio of the Soleus H reflex, a reliable neurophysiological index of spinal excitability and the Modified Ashworth Scale (MAS) for spasticity were evaluated by blinded raters before and after the stimulation protocols. Results: Patients receiving real iTBS showed a significant reduction of H / M amplitude ratio and MAS scores 1 week after the stimulation and persisting up to 2 weeks after the end of stimulation protocol. There were no significant effects for sham stimulation. Conclusions: These results show that iTBS, a safe, non‐invasive, well‐tolerated and feasible protocol, is a promising tool for the treatment of spasticity in MS.