title: Repetitive transcranial magnetic stimulation transiently reduces punding in Parkinson's disease: a preliminary study.
abstract: Amongst the impulse-control disorders (ICDs) associated with dopamine-replacement therapy in patients with Parkinson's disease (PD) is a repetitive, complex, stereotyped behaviour called punding. Disruption of the reciprocal loops between the striatum and structures in the prefrontal cortex (PFC) following dopamine depletion may predispose patients with PD to these behavioural disorders. The purpose of the present study was to assess the effects of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral PFC (DLPFC) on punding in PD. We used low-frequency (LF) rTMS in four PD patients presenting with punding. Punding was transiently reversed by LF-rTMS over the DLPFC without enhancing motor impairment. The effect was more sustained after right DLPFC rTMS. Therefore, LF-rTMS produced a transient beneficial effect in PD patients with punding, similar to that reported in PD patients with levodopa-induced dyskinesias. rTMS might have therapeutic potential for the treatment of punding and perhaps other ICDs in PD.
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Private Medical University, Salzburg, Austria, raffaele.nardone@asbmeran-o.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Nardone
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: De Blasi
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Höller
authors.forename: Monica
authors.initials: M
authors.lastname: Christova
authors.forename: Frediano
authors.initials: F
authors.lastname: Tezzon
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
authors.forename: Francesco
authors.initials: F
authors.lastname: Brigo
mesh_terms: D000368:Aged; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology* / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000628:therapy; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000379:methods*