Individuals with Parkinson’s disease (PD) have deficits in reach-to-grasp (RTG) execution and visuospatial processing which may be a result of dopamine deficiency in two brain regions: primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC). We hypothesized that improvement following M1 stimulation would be the result of a direct impact on motor execution; whereas, DLPFC stimulation would improve the role of DLPFC in visuospatial processing. The aim of pilot study was to investigate the effects of HF-rTMS on RTG performance by stimulating either M1 or DLPFC. Thirty individuals with PD participated (H&Y stages I–III). All of them were more affected on the right side. Participants were allocated into three groups. The DLPFC group received HF-rTMS over left DLPFC; while, the M1 group received HF-rTMS over left M1 of extensor digitorum communis representational area. The control group received HF-rTMS over the vertex. Before and immediately post HF-rTMS, right-hand RTG performance was measured under no barrier and barrier conditions. Additionally, TMS measures including motor-evoked-potential (MEP) amplitude and cortical silent period (CSP) were determined to verify the effects of HF-rTMS. For the results, there were no significant differences among the three groups. However, only the M1 group showed a significant decrease in movement time immediately after HF-rTMS for a barrier condition. Moreover, the M1 group showed a near-significant increase in hand opening and transport velocity. As for the DLPFC group, there was a near-significant increase in temporal transport-grasp coordination and a significant increase in velocity. Increased MEP amplitudes and a significantly longer CSP in the M1 and DLPFC groups confirmed the effects of HF-rTMS. Regarding non-significant results among the three groups, it is still inconclusive whether there were different effects of the rTMS on the two stimulation areas. This is a preliminary study demonstrating that HF-rTMS to M1 may improve RTG execution; whereas, HF-rTMS to DLPFC may improve visuospatial processing demands of RTG.

帕金森氏病（PD）的患者在可抓握（RTG）的执行和视觉空间处理方面存在缺陷，这可能是两个大脑区域多巴胺缺乏的结果：主要运动皮层（M1）和背外侧前额叶皮层（DLPFC）。我们假设，M1刺激后的改善将直接影响运动的执行。相反，DLPFC刺激将改善DLPFC在视觉空间处理中的作用。初步研究的目的是通过刺激M1或DLPFC来研究HF-rTMS对RTG性能的影响。30名PD患者参加了该项目（H＆Y阶段I–III）。所有这些都在右侧受到更大的影响。参加者分为三组。DLPFC组通过左DLPFC接收了HF-rTMS；而，M1组在指趾伸肌代表性区域左M1上方接受HF-rTMS。对照组在顶点接受了HF-rTMS。在HF-rTMS之前和之后，在无障碍物和无障碍条件下测量了右侧RTG性能。此外，确定了包括运动诱发电位（MEP）幅度和皮质沉默期（CSP）在内的TMS测量，以验证HF-rTMS的效果。对于结果，三组之间没有显着差异。但是，只有M1组在障碍状态下HF-rTMS后立即显示运动时间显着减少。此外，M1组的手张开和运输速度几乎增加。至于DLPFC组，暂时的运输-抓握协调性显着提高，速度显着提高。M1和DLPFC组中MEP幅度增加和CSP明显更长，证实了HF-rTMS的作用。关于三组之间的非显着性结果，rTMS是否对两个刺激区域产生不同的影响仍不确定。这是一项初步研究，表明对M1的HF-rTMS可以改善RTG的执行；HF-rTMS转换为DLPFC可能会改善RTG的视觉空间处理需求。这是一项初步研究，表明对M1进行HF-rTMS可以改善RTG的执行；HF-rTMS转换为DLPFC可能会改善RTG的视觉空间处理需求。这是一项初步研究，表明对M1进行HF-rTMS可以改善RTG的执行；HF-rTMS转换为DLPFC可能会改善RTG的视觉空间处理需求。