Primary orthostatic tremor (POT) is a rare progressive disabling tremor disorder characterized by symptoms of unsteadiness when standing, which improves upon walking or sitting and a distinct high frequency (13e18Hz) tremor discharge recorded from the leg muscles [1]. Treatment opportunities for POT are poor as the pharmacological therapies, including the propranolol, clonazepam and gabapentin and surgical intervention through thalamic deep brain stimulation, have shown limited success [2]. A recent functional MRI study found increased cerebellar activity in OT, which was modulated by repetitive transcranial magnetic stimulation (rTMS) delivered at low-frequency stimulation in an open-label design [3]. We examined in a randomized, double-blind placebocontrolled crossover-design study, whether low-frequency rTMS stimulation to the cerebellum improved standing, and balance and probed the underlying physiology with a well-established transcranial magnetic stimulation (TMS) paradigm of cerebellocortical inhibition (CBI) [4].

中文翻译：

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rTMS 在治疗原发性直立性震颤中的潜在作用

原发性直立性震颤 (POT) 是一种罕见的进行性致残性震颤疾病，其特征是站立时不稳，走路或坐下时症状有所改善，腿部肌肉记录到明显的高频 (13-18Hz) 震颤放电 [1]。POT 的治疗机会很少，因为药物疗法（包括普萘洛尔、氯硝西泮和加巴喷丁）以及通过丘脑深部脑刺激进行手术干预的成功率有限[2]。最近的一项功能性 MRI 研究发现 OT 中小脑活动增加，这是由重复经颅磁刺激 (rTMS) 在开放标签设计中以低频刺激提供的调节 [3]。我们在一项随机、双盲、安慰剂对照的交叉设计研究中进行了检查，