Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait

Brugger, Florian; Wegener, Regina; Baty, Florent; Walch, Julia; Krüger, Marie T.; Hägele-Link, Stefan; Bohlhalter, Stephan; Kägi, Georg

doi:10.3390/brainsci11030321

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Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait

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Department of Neurology, Kantonsspital St. Gallen, CH-9007 St. Gallen, Switzerland

Laboratory for Motion Analysis, Department of Paediatric Orthopaedics, Children’s Hospital of Eastern Switzerland, CH-9007 St. Gallen, Switzerland

Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, CH-9007 St. Gallen, Switzerland

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Department of Pulmology, Kantonsspital St. Gallen, CH-9007 St. Gallen, Switzerland

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Department of Neurosurgery, Kantonsspital St. Gallen, CH-9007 St. Gallen, Switzerland

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Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, D-79106 Freiburg, Germany

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Neurocenter, Luzerner Kantonsspital, CH-6000 Luzern, Switzerland

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Department of Neurology, University Hospital Bern, Inselspital, University of Bern, CH-3000 Bern, Switzerland

Author to whom correspondence should be addressed.

Academic Editors: Lorenzo Rocchi, Anna Latorre and Daniele Belvisi

Brain Sci. 2021, 11(3), 321; https://doi.org/10.3390/brainsci11030321

Received: 17 January 2021 / Revised: 25 February 2021 / Accepted: 26 February 2021 / Published: 3 March 2021

(This article belongs to the Special Issue Biomarkers and Novel Therapeutic Approaches for Movement Disorders: State-of-the-Art, Gaps and Perspectives)

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Abstract

Freezing of gait (FOG) in Parkinson’s disease (PD) occurs frequently in situations with high environmental complexity. The supplementary motor cortex (SMC) is regarded as a major network node that exerts cortical input for motor control in these situations. We aimed at assessing the impact of single-session (excitatory) intermittent theta burst stimulation (iTBS) of the SMC on established walking during FOG provoking situations such as passing through narrow spaces and turning for directional changes. Twelve PD patients with FOG underwent two visits in the off-medication state with either iTBS or sham stimulation. At each visit, spatiotemporal gait parameters were measured during walking without obstacles and in FOG-provoking situations before and after stimulation. When patients passed through narrow spaces, decreased stride time along with increased stride length and walking speed (i.e., improved gait) was observed after both sham stimulation and iTBS. These effects, particularly on stride time, were attenuated by real iTBS. During turning, iTBS resulted in decreased stride time along with unchanged stride length, a constellation compatible with increased stepping frequency. The observed iTBS effects are regarded as relative gait deterioration. We conclude that iTBS over the SMC increases stepping frequency in PD patients with FOG, particularly in FOG provoking situations. View Full-Text

Keywords: rTMS; freezing of gait; supplementary motor cortex; Parkinson’s disease

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Brugger, F.; Wegener, R.; Baty, F.; Walch, J.; Krüger, M.T.; Hägele-Link, S.; Bohlhalter, S.; Kägi, G. Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait. Brain Sci. 2021, 11, 321. https://doi.org/10.3390/brainsci11030321

AMA Style

Brugger F, Wegener R, Baty F, Walch J, Krüger MT, Hägele-Link S, Bohlhalter S, Kägi G. Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait. Brain Sciences. 2021; 11(3):321. https://doi.org/10.3390/brainsci11030321

Chicago/Turabian Style

Brugger, Florian, Regina Wegener, Florent Baty, Julia Walch, Marie T. Krüger, Stefan Hägele-Link, Stephan Bohlhalter, and Georg Kägi. 2021. "Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait" Brain Sciences 11, no. 3: 321. https://doi.org/10.3390/brainsci11030321

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Facilitatory rTMS over the Supplementary Motor Cortex Impedes Gait Performance in Parkinson Patients with Freezing of Gait

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