Neuronavigated repetitive transcranial magnetic stimulation improves depression, anxiety and motor symptoms in Parkinson’s disease

• Published in: Heliyon 2023-08, Vol.9 (8), p.e18364-e18364, Article e18364
• Main Authors: Jiang, Shuolin, Zhan, Cuijing, He, Peikun, Feng, Shujun, Gao, Yuyuan, Zhao, Jiehao, Wang, Limin, Zhang, Yuhu, Nie, Kun, Qiu, Yihui, Wang, Lijuan
• Format: Article
• Language: English
• Subjects: anxiety; Depression; Dorsolateral prefrontal cortex; motors; Neuronavigation; Parkinson disease; Parkinson’s disease; patients; Transcranial magnetic stimulation
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2023.e18364

Repetitive transcranial magnetic stimulation (rTMS) is a potential treatment option for Parkinson’s disease patients with depression (DPD), but conflicting results in previous studies have questioned its efficacy. To investigate the safety and efficacy of neuronavigated high-frequency rTMS at the left DLPFC in DPD patients, we conducted a randomized, double-blind, sham-controlled study (NCT04707378). Sixty patients were randomly assigned to either a sham or active stimulation group and received rTMS for ten consecutive days. The primary outcome was HAMD, while secondary outcomes included HAMA, MMSE, MoCA and MDS-UPDRS-III. Assessments were performed at baseline, immediately after treatment, 2 weeks, and 4 weeks post-treatment. The GEE analysis showed that the active stimulation group had significant improvements in depression, anxiety, and motor symptoms at various time points. Specifically, there were significant time-by-group interaction effects in depression immediately after treatment (β, −4.34 [95% CI, −6.90 to −1.74; P = 0.001]), at 2 weeks post-treatment (β, −3.66 [95% CI, −6.43 to −0.90; P = 0.010]), and at 4 weeks post-treatment (β, −4.94 [95% CI, −7.60 to −2.29; P