Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation technique with great potential in the treatment of Parkinson's disease (PD). This study aimed to investigate the clinical efficacy of accelerated rTMS and to understand the underlying neural mechanism. In a double‐blinded way, a total of 42 patients with PD were randomized to receive real (n = 22) or sham (n = 20) continuous theta‐burst stimulation (cTBS) on the left supplementary motor area (SMA) for 14 consecutive days. Patients treated with real cTBS, but not with sham cTBS, showed a significant improvement in Part III of the Unified PD Rating Scale (p < .0001). This improvement was observed as early as 1 week after the start of cTBS treatment, and maintained 8 weeks after the end of the treatment. These findings indicated that the treatment response was swift with a long‐lasting effect. Imaging analyses showed that volume of the left globus pallidus (GP) increased after cTBS treatment. Furthermore, the volume change of GP was mildly correlated with symptom improvement and associated with the baseline fractional anisotropy of SMA‐GP tracts. Together, these findings implicated that the accelerated cTBS could effectively alleviate motor symptoms of PD, maybe by modulating the motor circuitry involving the SMA‐GP pathway.

中文翻译：

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结构与帕金森病中潜在的加速磁刺激相关

重复经颅磁刺激 (rTMS) 是一种非侵入性神经调节技术，在治疗帕金森病 (PD) 方面具有巨大潜力。本研究旨在调查加速 rTMS 的临床疗效并了解潜在的神经机制。以双盲方式，总共 42 名 PD 患者随机接受左侧辅助运动区 (SMA) 的真实 ( n = 22) 或假 ( n = 20) 连续 theta-burst 刺激 (cTBS) 14连续多日。接受真实 cTBS 而非假 cTBS 治疗的患者在统一 PD 评定量表的第三部分中显示出显着改善（p< .0001）。早在 cTBS 治疗开始后 1 周就观察到这种改善，并在治疗结束后保持 8 周。这些发现表明治疗反应迅速，效果持久。影像学分析显示 cTBS 治疗后左侧苍白球 (GP) 的体积增加。此外，GP的体积变化与症状改善轻度相关，并与SMA-GP束的基线各向异性分数相关。总之，这些发现表明加速 cTBS 可以有效缓解 PD 的运动症状，可能是通过调节涉及 SMA-GP 通路的运动电路。