A randomized double-blind sham-controlled clinical trial on the effectiveness of RTMS on lower extremity spasticity in patients with hereditary spastic paraplegia

• Published in: Journal of the neurological sciences 2019-10, Vol.405, p.58-59
• Main Authors: Bastani, P. Barahim, Abdi, S.
• Format: Article
• Language: English
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2019.10.876

Hereditary Spastic Paraplegia (HSP) consists of a group of conditions involving a wide array of genes, all characterized by slowly progressive weakness in lower limbs resulting in gait abnormalities. 8 patients, categorized by Fink's criteria as definite or probable HSP, entered the study. They were randomly assigned to 5 sessions of active 5 Hz-rTMS (n = 4) or control sham rTMS (n = 4). All patients were evaluated prior to the intervention, upon completion of the rTMS and 1 month after that. We used modified Ashworth Scale (MAS), 10 Meter Walking Test (10MWT), Fugl Meyer Assessment (FMA) methods, the H Reflex and H/M ratio and SF-36 quality of life questionnaire for evaluation. The primary end point was decrease in knee spasticity based on modified Ashworth Scale (MAS). We performed both mixed model analysis and independent sample t-test comparing the variables in active and sham group at the given times. Active rTMS resulted in a significant reduction of MAS in the knees compared to the sham both upon completion of the intervention (1.75 vs. 2.68 - P