Abstract Details

Title Repetitive transcranial magnetic stimulation with H coil in Progressive Supranuclear Palsy: a double-blind, placebo-controlled, crossover study

Topic Movement Disorders

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-001

Objective To explore the safety and efficacy of rTMS and passive cycling in PSP.

Background Progressive Supranuclear Palsy (PSP) is a neurodegenerative parkinsonism without effective treatment. Some interventions suh as passive cycling and high frequency, excitatory repetitive transcranial magnetic stimulation (rTMS) of the frontal motor and extramotor cortex have been reported beneficial in Parkinsonian syndromes. No data are available on PSP.

Design/Methods Crossover, double-blind study on 20 subjects with PSP. Two cycles of active / sham rTMS (11 sessions/cycle during a 3-weeks period) with a month washout. Lower limb M1 (20 Hz, 1600 stimuli) and prefrontal areas (10 Hz, 840 stimuli) were stimulated with H-coil during passive leg cycling. Evaluations (PSP rating scale-PSPRS, UPDRS, TUG, 6-minute-walk, 10-meter-walk, hand/leg tapping, blinding questionnaire, PSPQoL, clinical global impression of improvement, apathy evaluation scale, NRS of global health, neuropsychological tests) were performed at baseline (T0) and at 0-1 month after each treatment.

Results 18 patients completed all evaluations. Overall rTMS was well tolerated with minor adverse events, significantly more frequently during real stimulation compared to sham (p < 0,001) and blinding questionnaires did not reveal significant unblinding. Significant advantage of Real vs Sham treatment was found for PSPRS part V (limbs), NRS improvement (p=0,049) and caregiver CGI-I (p=0,023), motor threshold decrease (p=0,035).

Conclusions

This is the first randomized placebo-controlled study on rTMS, coupled with passive cycling, in PSP. rTMS appeared to be safe and generally well tolerated, with a positive effect on motor performances and subjective judgement by the patient and caregiver as well as on neurophysiological measures of motor excitability. Further confirmatory studies exploring predictive factors for treatment response are needed.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Letizia M. Leocani, MD (University Vita-Salute San Raffaele, INSPE)	Dr. Leocani has received personal compensation in the range of $0-$499 for serving as a Consultant for Roche . Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Med-ex learning.

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