Effects of repetitive transcranial magnetic stimulation on voice and speech in Parkinson's disease.
OBJECTIVE
To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on vocal function in Parkinson's disease (PD).


METHODS
Two different sets of rTMS parameters were investigated on 30 patients with PD: active or sham 15 Hz rTMS of the left dorsolateral prefrontal cortex (LDLPFC) (110% of motor threshold (MT), 3000 pulses per session) and active 5 Hz rTMS of the primary motor cortex (M1)-mouth area (90% MT, 2250 pulses per session). A blind rater evaluated speech characteristics (acoustic and perceptual analysis of voice) and voice-related quality of life (V-RQOL).


RESULTS
rTMS of LDLPFC resulted in mood amelioration and subjective improvement of the V-RQOL only (71.9% improvement, P < 0.001), but not in objective measures such as fundamental frequency (P = 0.86) and voice intensity (P = 0.99). On the other hand, rTMS of M1-mouth induced a significant improvement of the fundamental frequency (12.9% for men and 7.6% for women, P < 0.0001) and voice intensity (20.6%, P < 0.0001).


CONCLUSIONS
Our findings provide initial evidence that rTMS of the primary motor cortex might yield a beneficial effect on vocal function in PD.
Dias
A E
AE
Department of Neurology and Psychiatry, University of Sao Paulo, Sao Paulo, Brazil.
Barbosa
E R
ER
Coracini
K
K
Maia
F
F
Marcolin
M A
MA
Fregni
F
F
D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex; D010300:Parkinson Disease / Q000150:complications*; D017397:Prefrontal Cortex; D013061:Speech Acoustics; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D014832:Voice Disorders / Q000209:etiology / Q000628:therapy*; D014833:Voice Quality