Immediate effect of spinal magnetic stimulation on camptocormia in Parkinson's disease.
OBJECTIVE
Spinal cord stimulation is a potential therapeutic option for the treatment of Parkinson's disease (PD)-associated symptoms. Repetitive trans-spinal magnetic stimulation (rTSMS) is a non-invasive and safe alternative for stimulation of spinal pathways that has not been studied for therapeutic efficacy in PD. We assessed the benefits of rTSMS on camptocormia, an often treatment-resistant postural abnormality observed in PD patients.


METHODS
We compared rTSMS to sham stimulation in PD patients with camptocormia in a single-centre, randomised, single-blind, crossover, placebo-controlled study. PD patients with camptocormia were administered a single trial of rTSMS (a train of 40 stimuli) or sham treatment followed 1 week later by the alternate treatment. Primary outcome measure was thoracolumbar spine flexion angle in the standing position immediately after the trial.


RESULTS
Of 320 PD patients examined, 37 had concomitant camptocormia and were randomly assigned to either the rTSMS first group (n=19) or sham first group (n=18). Flexion angle in the standing position decreased by a mean of 10.9° (95% CI 8.1 to 13.65) after rTSMS but remained unchanged after sham stimulation (mean, -0.1°; 95% CI -0.95 to 0.71). The flexion angle while sitting (secondary outcome) decreased by 8.1° (95% CI 5.89 to 10.25) after rTSMS, whereas sham treatment had no significant effect (mean, -0.8°; 95% CI -1.62 to 0.05).


CONCLUSIONS
We found an immediate beneficial effect of rTSMS on camptocormia in PD patients. Although the effect was transient, this successful trial justifies further studies to test if repeated rTSMS treatments can induce longer term improvements in camptocormia associated with PD.


BACKGROUND
UMIN Clinical Trials Registry: UMIN000011495.
Department of Neurology, Tokushima National Hospital, National Hospital Organization, Yoshinogawa, Tokushima, Japan.
Yoshiharu
Y
Arii
Department of Rehabilitation, Tokushima National Hospital, National Hospital Organization, Yoshinogawa, Tokushima, Japan.
Yuki
Y
Sawada
Department of Neurology, Tokushima National Hospital, National Hospital Organization, Yoshinogawa, Tokushima, Japan.
Kazuyuki
K
Kawamura
Department of Clinical Research, Tokushima National Hospital, National Hospital Organization, Yoshinogawa, Tokushima, Japan.
Sayaka
S
Miyake
Department of Rehabilitation, Tokushima National Hospital, National Hospital Organization, Yoshinogawa, Tokushima, Japan.
Yasuo
Y
Taichi
Department of Clinical Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
Yuishin
Y
Izumi
Department of Clinical Research, Tokushima National Hospital, National Hospital Organization, Yoshinogawa, Tokushima, Japan.
Yukiko
Y
Kuroda
Department of Neurology, Tokushima National Hospital, National Hospital Organization, Yoshinogawa, Tokushima, Japan.
Toshio
T
Inui
Department of Clinical Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
Ryuji
R
Kaji
Department of Neurology, Tokushima National Hospital, National Hospital Organization, Yoshinogawa, Tokushima, Japan Department of Clinical Research, Tokushima National Hospital, National Hospital Organization, Yoshinogawa, Tokushima, Japan.
Takao
T
Mitsui
D000368:Aged; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D055909:Magnetic Field Therapy / Q000379:methods*; D008297:Male; D009134:Muscular Atrophy, Spinal / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D010300:Parkinson Disease / Q000150:complications* / Q000628:therapy; D011187:Posture; D016037:Single-Blind Method; D013121:Spinal Curvatures / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D013131:Spine / Q000473:pathology; D016896:Treatment Outcome
Movement Disorders; Parkinson's Disease