Won Hyuk Chang, Min Su Kim, Jin Whan Cho, Jinyoung Youn, Yun Kwan Kim, Sun Woong Kim, Ahee Lee, Yun-Hee Kim
Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
DOI: 10.2340/16501977-2140

Objective: To investigate the potential of cumulative high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) on freezing of gait in atypical Parkinsonism.
Design: Randomized, single-blinded, crossover study with a blinded observer.
Participants: Eight patients with atypical Parkinsonism.
Methods: All participants received HF-rTMS over the lower leg primary motor cortex (M1-LL) for 5 consecutive days. Alternative sham stimulation was also administered with a 2-week wash-out period. Freezing of Gait Questionnaire (FOG-Q), turn steps in the modified Standing Start 180° Turn Test, the Timed Up and Go (TUG) task, and the Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) were performed before, after, and one week after rTMS.
Results: All participants completed this study without any significant adverse effects. FOG-Q and turn steps revealed significant improvements over time in the rTMS compared with the sham stimulation (χ2=6. 067, p=0. 048 and χ2=9. 083, p=0. 011). In addition, the TUG task and UPDRS-III showed significant improvements over time in the rTMS compared with the sham stimulation (χ2=7. 200, p=0. 02 and χ2=7. 000, p=0. 030).
Conclusion: Cumulative HF-rTMS over the M1-LL might be effective for improving freezing of gait in patients with atypical Parkinsonism. Further investigation with a large number of participants is needed to clarify the effects of HF- rTMS on freezing of gait in atypical Parkinsonism.