BACKGROUND Stimulatory cerebellar TMS is a promising tool to improve motor control in neurodegenerative disorders. OBJECTIVE/HYPOTHESIS Our goal was to use 10Hz cerebellar rTMS to augment cerebellar-brain inhibition (CBI) for improved postural stability and speech in patients with progressive supranuclear palsy (PSP). METHODS We performed CBI assessments with neuronavigation before and after high frequency cerebellar rTMS or sham TMS in two patients with PSP, using a double cone coil for the conditioning pulse and a figure-of-eight coil for the test pulse and treatments. We collected posturography data and speech samples before and after treatment. RESULTS After treatment, CBI increased by 50% in subject 1 and by 32% in subject 2, and postural stability and speech improved. The protocol was well tolerated, but the sham was not consistently believable. CONCLUSION Cerebellar rTMS may improve postural stability and speech in PSP, but cooled coils with vibrotactile sham capability are needed for larger future studies.

中文翻译：

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小脑 rTMS 用于进行性核上性麻痹的运动控制

背景刺激性小脑TMS是改善神经退行性疾病中运动控制的有前途的工具。目标/假设我们的目标是使用 10Hz 小脑 rTMS 来增强小脑脑抑制 (CBI)，以改善进行性核上性麻痹 (PSP) 患者的姿势稳定性和言语。方法我们在两名 PSP 患者的高频小脑 rTMS 或假 TMS 之前和之后使用神经导航进行 CBI 评估，使用双锥形线圈作为调理脉冲，使用 8 字形线圈进行测试脉冲和治疗。我们收集了治疗前后的姿势图数据和语音样本。结果 治疗后，受试者 1 的 CBI 增加了 50%，受试者 2 的 CBI 增加了 32%，并且姿势稳定性和语言能力得到改善。该协议具有良好的耐受性，但这个骗局并不总是可信的。结论 小脑 rTMS 可以改善 PSP 中的姿势稳定性和言语，但未来更大规模的研究需要具有振动触觉假手术能力的冷却线圈。