Effects of intermittent theta burst stimulation on spasticity in patients with multiple sclerosis.
OBJECTIVE
Spasticity is a common disorder and a major cause of long-term disability in patients with multiple sclerosis (MS). Our aim was to evaluate whether a recently developed repetitive transcranial magnetic stimulation protocol, the intermittent theta burst stimulation (iTBS) is effective in modulating lower limb spasticity in MS patients.


METHODS
Twenty MS patients were pseudorandomized to undergo a 2-week daily sessions of real or sham iTBS protocol. The H/M amplitude ratio of the Soleus H reflex, a reliable neurophysiological index of spinal excitability and the Modified Ashworth Scale (MAS) for spasticity were evaluated by blinded raters before and after the stimulation protocols.


RESULTS
Patients receiving real iTBS showed a significant reduction of H/M amplitude ratio and MAS scores 1 week after the stimulation and persisting up to 2 weeks after the end of stimulation protocol. There were no significant effects for sham stimulation.


CONCLUSIONS
These results show that iTBS, a safe, non-invasive, well-tolerated and feasible protocol, is a promising tool for the treatment of spasticity in MS.
Dipartimento di Neuroscienze, Clinica Neurologica, Università Tor Vergata, Rome, Italy. francesco808@virgilio.it
F
F
Mori
C
C
Codecà
H
H
Kusayanagi
F
F
Monteleone
L
L
Boffa
A
A
Rimano
G
G
Bernardi
G
G
Koch
D
D
Centonze
D000328:Adult; D000368:Aged; D004576:Electromyography; D019054:Evoked Potentials, Motor; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000503:physiopathology / Q000628:therapy*; D009128:Muscle Spasticity / Q000503:physiopathology / Q000628:therapy*; D012018:Reflex / Q000502:physiology; D012720:Severity of Illness Index; D013116:Spinal Cord / Q000503:physiopathology; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome