Effects of intermittent theta burst stimulation on spasticity in patients with multiple sclerosis
Article first published online: 23 OCT 2009
© 2009 The Author(s). Journal compilation © 2009 EFNS
European Journal of Neurology
Volume 17, Issue 2, pages 295–300, February 2010
How to Cite
Mori, F., Codecà, C., Kusayanagi, H., Monteleone, F., Boffa, L., Rimano, A., Bernardi, G., Koch, G. and Centonze, D. (2010), Effects of intermittent theta burst stimulation on spasticity in patients with multiple sclerosis. European Journal of Neurology, 17: 295–300. doi: 10.1111/j.1468-1331.2009.02806.x
- Issue published online: 13 JAN 2010
- Article first published online: 23 OCT 2009
- Received 9 March 2009 Accepted 11 August 2009
- H reflex;
- motor-evoked potentials;
- stretch reflex;
- transcranial magnetic stimulation
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.