Background. Repetitive transcranial magnetic stimulation (rTMS) is a promising therapeutic tool for Parkinson’s disease (PD), and many stimulation targets have been implicated. We aim to explore whether low-frequency rTMS over the right dorsolateral prefrontal cortex (DLPFC) improves motor and nonmotor symptoms of individuals with PD. Methods. We conducted a randomized, single-blind, sham-controlled parallel trial to compare the effect of 10 consecutive daily sessions of 1 Hz rTMS over right DLPFC on individuals with idiopathic PD between active and sham rTMS group. Primary outcomes were changes in Unified Parkinson’s Disease Rating Scale (UPDRS) part III and Nonmotor Symptom Questionnaire (NMSQ). Secondary outcomes were changes in UPDRS total score, Hamilton Rating Scale for Depression (HRSD), Pittsburgh Sleep Quality Index (PSQI), and Montreal Cognitive Assessment (MoCA). Assessments were completed at baseline, after treatment, and at 1 month, 3 months, and 6 months after treatment. Results. A total of 33 participants with PD were randomized. All participants completed the study and no severe adverse effect was noticed. Compared to baseline, active rTMS showed significant improvements in UPDRS part III and NMSQ at 1 month. Change of scores on UPDRS part III, HRSD, and PSQI persisted for 3 months after rTMS intervention. The beneficial effect on cognitive performance assessed by MoCA was maintained for at least 6 months in the follow-up. No significant changes were observed in the group with sham rTMS. Conclusions. Low-frequency rTMS of right DLPFC could be a potential selection in managing motor and nonmotor symptoms in PD.

中文翻译：

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帕金森病右背外侧前额叶皮层低频重复经颅磁刺激

背景。重复经颅磁刺激 (rTMS) 是帕金森病 (PD) 的一种有前途的治疗工具，并且涉及许多刺激目标。我们旨在探讨右背外侧前额叶皮层 (DLPFC) 上的低频 rTMS 是否能改善 PD 患者的运动和非运动症状。方法. 我们进行了一项随机、单盲、假对照的平行试验，以比较在活动组和假 rTMS 组之间连续 10 次每天使用 1 Hz rTMS 而非右侧 DLPFC 对特发性 PD 个体的影响。主要结果是统一帕金森病评定量表 (UPDRS) 第 III 部分和非运动症状问卷 (NMSQ) 的变化。次要结果是 UPDRS 总分、汉密尔顿抑郁量表 (HRSD)、匹兹堡睡眠质量指数 (PSQI) 和蒙特利尔认知评估 (MoCA) 的变化。在基线、治疗后以及治疗后 1 个月、3 个月和 6 个月时完成评估。结果. 共有 33 名 PD 参与者被随机分配。所有参与者都完成了研究，没有发现严重的不良反应。与基线相比，主动 rTMS 在 1 个月时 UPDRS 第 III 部分和 NMSQ 有显着改善。在 rTMS 干预后，UPDRS 第 III 部分、HRSD 和 PSQI 的分数变化持续了 3 个月。MoCA 评估的对认知表现的有益影响在随访中至少维持了 6 个月。假 rTMS 组未观察到显着变化。结论。右侧 DLPFC 的低频 rTMS 可能是管理 PD 运动和非运动症状的潜在选择。