Effects of cerebellar repetitive transcranial magnetic stimulation plus physiotherapy in spinocerebellar ataxias - A randomized clinical trial

CNS Neurosci Ther. 2024 Jun;30(6):e14797. doi: 10.1111/cns.14797.

Abstract

Background: In absence of drug therapy options, standard treatment for spinocerebellar ataxia consists of symptomatic physiotherapy and speech therapy. New therapeutic options are urgently needed. Transcranial magnetic stimulation is a promising therapeutic option, but applicability is limited by lengthy duration of stimulation protocols.

Methods: In this randomized sham controlled clinical trial, patients were assigned to verum (n = 15) or sham (n = 18) cerebellar transcranial magnetic stimulation. To yield best possible treatment effects, both intervention groups received intensified physiotherapy for the duration of the study.

Results: Ataxia severity was reduced by 1.6 points on the Scale for assessment and Rating of Ataxia among patients in the verum group (p < 0.001). Clinical improvement was significantly larger in the verum group, compared to the sham group (p < 0.01). The treatment effect was mainly carried by improved appendicular coordination. Patients in the verum group also significantly improved in the 8 Meter Walk Test (p < 0.05) and PATA rate (p < 0.01).

Conclusions: Cerebellar rTMS ameliorates ataxia severity in patient with spinocerebellar ataxia. Condensing treatment duration to only 5 days without reduction of treatment effects facilitates applicability and therefore broadens availability to larger patient populations.

Keywords: SCA; TMS; ataxia; cerebellum; transcranial magnetic stimulation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Cerebellum*
  • Combined Modality Therapy / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities*
  • Severity of Illness Index
  • Spinocerebellar Ataxias* / therapy
  • Transcranial Magnetic Stimulation* / methods
  • Treatment Outcome