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Abstract Details

Cerebellar rTMS in Progressive Supranuclear Palsy Speech Disorder
Movement Disorders
P1 - Poster Session 1 (11:45 AM-12:45 PM)
5-027
To investigate the effects of cerebellar rTMS on posture, speech, and swallowing in patients with Progressive Supranuclear Palsy (PSP).

PSP is characterized by early and severe postural instability and supranuclear gaze palsy. Early speech and swallowing impairment is another debilitating feature. Traditional treatments in parkinsonism have proven ineffective for these axial symptoms, highlighting the need for novel therapeutic approaches. Cerebellar rTMS has emerged as a promising intervention to improve motor control in various conditions.
In this double-blind randomized controlled trial 18 PSP patients were randomly assigned to undergo 10 sessions of active rTMS (N=9) or sham (N=9). Active treatment consisted of 20-minutes of magnetic stimulation with a 10 Hz frequency over both cerebellar hemispheres. Outcome assessment was performed at baseline, immediately after and at 2 weeks following the last session. Balance was assessed using motion analysis, step plate posturography, and kinematic movement analysis. Dysarthria was evaluated using Wannberg auditory and perceptual dysarthria assessment protocol and swallowing function using the Persian version of the Northwestern Dysphagia Patient Check Sheet. We assessed quality of life using the Parkinson's disease quality of life questionnaire (PDQL).

Nine patients from the active (6 male) and 5 from the sham group (5 male) were analyzed. Speech and swallowing improved significantly in both groups, however, there was no significant difference between groups. We found no significant difference in the balance parameters. PDQL assessment showed a significant improvement within the active arm (26 scores) but not the control arm (18 scores); however, the change was not significant comparing the two groups. 
Our study showed that stimulatory cerebellar rTMS is well tolerated in PSP patients, however, not effective on speech and swallowing function or balance. Larger future studies may reveal if cerebellar rTMS can improve the quality of life in PSP and the specific aspects that might be affected.
Authors/Disclosures
Nahid Olfati, MD (UC San Diego)
PRESENTER 		Dr. Olfati has nothing to disclose.
Mina Farahnezhad, Jr., MD Dr. Farahnezhad has nothing to disclose.
Ali Shoeibi (Mashhad University of Medical Sciences) No disclosure on file
Ebrahim Abdollahian (Mashhad University of Medical Sciences) No disclosure on file
Hamid Reza Kobravi, PhD Dr. Kobravi has nothing to disclose.
Hamideh Ghaemi, PhD Dr. Ghaemi has nothing to disclose.
Saeed Akhlaghi, PhD Dr. Akhlaghi has nothing to disclose.
niloufar keshvari, Master's degree Miss keshvari has nothing to disclose.
Mobina Ramezani, Master degree Miss Ramezani has nothing to disclose.
Amir Khanmirzaei, MD Dr. Khanmirzaei has nothing to disclose.