- Email: [email protected]
P032 Repetitive transcranial magnetic stimulation on freezing of gait in Parkinson’s disease
e24
Abstracts / Clinical Neurophysiology 128 (2017) e1–e163
over bilateral mylohyoid motor cortices can be utilized as an additional treatment strategy with traditional dysphagia therapy.
Figure 2
doi:10.1016/j.clinph.2016.10.158
P031 Transcranial direct current stimulation in mesial temporal lobe epilepsy and hippocampal sclerosis—D. San Juan Orta a,b,*, A.A. Espinoza López a, R. Vazquez Gregorio a, C. Trenado c, M. Fernandez Gonzalez-Aragon a, L. Morales-Quezada d,e, A. Hernandez Ruíz f, F. Hernandez-González g, A. Alcaraz-Guzman h, D.J. Anschel i, F. Fregni d,e (a National Institute of Neurology and Neurosurgery, Clinical Neurophysiology, Mexico City, Mexico, b Dresden International University, Division of Health Care Sciences. Center for Clinical Research and Management Education, Dresden, Mexico, c University Hospital Düsseldorf, Institute of Clinical Neuroscience and Medical Psychology, Düsseldorf, Germany, d Harvard Medical School, Harvard University, Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, United States, e Harvard Medical School, Harvard University, Program in Placebo Studies, Beth Israel Deaconess Medical Center, Boston, United States, f National Polytechnic Institute, Superior School of Medicine, Mexico City, Mexico, g Autonomous University of Aguascalientes, Superior School of Medicine, Aguascalientes, Mexico, h University of Colima, Superior School of Medicine, Colima, Mexico, i St. Charles Hospital, Comprehensive Epilepsy Center of Long Island, Port Jefferson, United States) ⇑
Corresponding author.
Background: Transcranial direct current stimulation (tDCS) has been tested in heterogeneous refractory epilepsy studies. However, are inconclusive and the parameters were not well defined. Objectives: To evaluate safety and efficacy of two protocols of tDCS in adult patients with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS). Methods: Randomized clinical trial, placebo-controlled, doubleblind with 3 arms; 3 sessions, 5 sessions and placebo stimulation. Frequency of seizures (SZs), interictal epileptiform discharges (IEDs) and adverse effects (AEs) were registered before and after stimulations, and at 30 and 60 days of follow-up. We used descriptive statistics, k-related samples Friedman’s test and relative risk (RR) estimation for analysis.
Figure 1
Results: We included 28 patients (3d n = 12, 5d n = 8, placebo n8), 16/28 (57%) men, age 37.8(±10.9) years old. We found a significant reduction effect of cathodal tDCS on the frequency of SZs at first (p = 0.001) and second (p = 0.0001) months of follow-up compared to baseline in the 3 arms (p = 0.0001). The mean reduction of SZs frequency at two months in both active groups was significantly higher than placebo (-48% vs 6.25%, p = 0.041) in all groups. Only minor AEs were reported. Conclusions: Cathodal tDCS therapies of 3 and 5 sessions decreased the frequency of SZs and IEDs (only between baseline and immediately post-tDCS) in adult patients with MTLE-HS compared to placebo, with mild AEs. doi:10.1016/j.clinph.2016.10.159
P032 Repetitive transcranial magnetic stimulation on freezing of gait in Parkinson’s disease—S.Y. Kang a,*, Y.H. Sohn b, S.J. Kim c (a Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Department of neurology, Hwaseong, South Korea, b Yonsei University College of Medicine, Department of Neurology, Seoul, South Korea, c Inje University College of Medicine, Department of Neurology, Busan, South Korea) ⇑
Corresponding author.
Question: Freezing of gait (FOG) is frustrating problem in Parkinson’s disease (PD). There is no effective treatment. The aim of study is to find brain stimulation areas showing more effective response. Methods: Ten patients with PD were participated. All of them had FOG. Repetitive transcranial magnetic stimulation (rTMS) were applied to brain for two consecutive days. We measured the number of steps, completion time and freezing episodes during the standwalk-sit (SWS) test before and after intervention. We also tested freezing episodes on two FOG provoking tasks before and after rTMS treatment. Two stimulation sites of their brain were pseudorandomly assigned: the motor cortex (MC) or supplementary motor cortex (SMC). Patients were blinded as to which site was selected. Four rTMS blocks were delivered, each 10 min apart in each day. One block consisted of 15 25 Hz of 1-s duration with an intertrain interval of 10 s at 100% resting motor threshold. Results: The freezing episodes during the SWS test were more reduced in SMC stimulation than in MC (p = 0.053). Conclusion: Our study suggests that SMC stimulation may be a more appropriate candidate in PD patients with freezing of gait. doi:10.1016/j.clinph.2016.10.160
Abstracts / Clinical Neurophysiology 128 (2017) e1–e163
over bilateral mylohyoid motor cortices can be utilized as an additional treatment strategy with traditional dysphagia therapy.
Figure 2
doi:10.1016/j.clinph.2016.10.158
P031 Transcranial direct current stimulation in mesial temporal lobe epilepsy and hippocampal sclerosis—D. San Juan Orta a,b,*, A.A. Espinoza López a, R. Vazquez Gregorio a, C. Trenado c, M. Fernandez Gonzalez-Aragon a, L. Morales-Quezada d,e, A. Hernandez Ruíz f, F. Hernandez-González g, A. Alcaraz-Guzman h, D.J. Anschel i, F. Fregni d,e (a National Institute of Neurology and Neurosurgery, Clinical Neurophysiology, Mexico City, Mexico, b Dresden International University, Division of Health Care Sciences. Center for Clinical Research and Management Education, Dresden, Mexico, c University Hospital Düsseldorf, Institute of Clinical Neuroscience and Medical Psychology, Düsseldorf, Germany, d Harvard Medical School, Harvard University, Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, United States, e Harvard Medical School, Harvard University, Program in Placebo Studies, Beth Israel Deaconess Medical Center, Boston, United States, f National Polytechnic Institute, Superior School of Medicine, Mexico City, Mexico, g Autonomous University of Aguascalientes, Superior School of Medicine, Aguascalientes, Mexico, h University of Colima, Superior School of Medicine, Colima, Mexico, i St. Charles Hospital, Comprehensive Epilepsy Center of Long Island, Port Jefferson, United States) ⇑
Corresponding author.
Background: Transcranial direct current stimulation (tDCS) has been tested in heterogeneous refractory epilepsy studies. However, are inconclusive and the parameters were not well defined. Objectives: To evaluate safety and efficacy of two protocols of tDCS in adult patients with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS). Methods: Randomized clinical trial, placebo-controlled, doubleblind with 3 arms; 3 sessions, 5 sessions and placebo stimulation. Frequency of seizures (SZs), interictal epileptiform discharges (IEDs) and adverse effects (AEs) were registered before and after stimulations, and at 30 and 60 days of follow-up. We used descriptive statistics, k-related samples Friedman’s test and relative risk (RR) estimation for analysis.
Figure 1
Results: We included 28 patients (3d n = 12, 5d n = 8, placebo n8), 16/28 (57%) men, age 37.8(±10.9) years old. We found a significant reduction effect of cathodal tDCS on the frequency of SZs at first (p = 0.001) and second (p = 0.0001) months of follow-up compared to baseline in the 3 arms (p = 0.0001). The mean reduction of SZs frequency at two months in both active groups was significantly higher than placebo (-48% vs 6.25%, p = 0.041) in all groups. Only minor AEs were reported. Conclusions: Cathodal tDCS therapies of 3 and 5 sessions decreased the frequency of SZs and IEDs (only between baseline and immediately post-tDCS) in adult patients with MTLE-HS compared to placebo, with mild AEs. doi:10.1016/j.clinph.2016.10.159
P032 Repetitive transcranial magnetic stimulation on freezing of gait in Parkinson’s disease—S.Y. Kang a,*, Y.H. Sohn b, S.J. Kim c (a Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Department of neurology, Hwaseong, South Korea, b Yonsei University College of Medicine, Department of Neurology, Seoul, South Korea, c Inje University College of Medicine, Department of Neurology, Busan, South Korea) ⇑
Corresponding author.
Question: Freezing of gait (FOG) is frustrating problem in Parkinson’s disease (PD). There is no effective treatment. The aim of study is to find brain stimulation areas showing more effective response. Methods: Ten patients with PD were participated. All of them had FOG. Repetitive transcranial magnetic stimulation (rTMS) were applied to brain for two consecutive days. We measured the number of steps, completion time and freezing episodes during the standwalk-sit (SWS) test before and after intervention. We also tested freezing episodes on two FOG provoking tasks before and after rTMS treatment. Two stimulation sites of their brain were pseudorandomly assigned: the motor cortex (MC) or supplementary motor cortex (SMC). Patients were blinded as to which site was selected. Four rTMS blocks were delivered, each 10 min apart in each day. One block consisted of 15 25 Hz of 1-s duration with an intertrain interval of 10 s at 100% resting motor threshold. Results: The freezing episodes during the SWS test were more reduced in SMC stimulation than in MC (p = 0.053). Conclusion: Our study suggests that SMC stimulation may be a more appropriate candidate in PD patients with freezing of gait. doi:10.1016/j.clinph.2016.10.160