title: Effect of Repetitive Transcranial Magnetic Stimulation on fMRI Resting-State Connectivity in Multiple System Atrophy.
abstract: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation technique that has been used to treat neurological and psychiatric conditions. Although results of rTMS intervention are promising, so far, little is known about the rTMS effect on brain functional networks in clinical populations. In this study, we used a whole-brain connectivity analysis of resting-state functional magnetic resonance imaging data to uncover changes in functional connectivity following rTMS intervention and their association with motor symptoms in patients with multiple system atrophy (MSA). Patients were randomized to active rTMS or sham rTMS groups and completed a 10-session 5-Hz rTMS treatment over the left primary motor area. The results showed significant rTMS-related changes in motor symptoms and functional connectivity. Specifically, (1) significant improvement of motor symptoms was observed in the active rTMS group, but not in the sham rTMS group; and (2) several functional links involving the default mode, cerebellar, and limbic networks exhibited positive changes in functional connectivity in the active rTMS group. Moreover, the positive changes in functional connectivity were associated with improvement in motor symptoms for the active rTMS group. The present findings suggest that rTMS may improve motor symptoms by modulating functional links connecting to the default mode, cerebellar, and limbic networks, inferring a future therapeutic candidate for patients with MSA.
authors.affiliation: 1 Brain Imaging and Analysis Center, Duke University Medical Center , Durham, North Carolina.|2 Department of Psychiatry and Behavioral Sciences, Duke University Medical Center , Durham, North Carolina.
authors.forename: Ying-hui
authors.initials: YH
authors.lastname: Chou
authors.affiliation: 3 Department of Radiology, Peking Union Medical College Hospital , Beijing, China .
authors.forename: Hui
authors.initials: H
authors.lastname: You
authors.affiliation: 4 Department of Neurology, Peking Union Medical College Hospital , Beijing, China .
authors.forename: Han
authors.initials: H
authors.lastname: Wang
authors.affiliation: 3 Department of Radiology, Peking Union Medical College Hospital , Beijing, China .
authors.forename: Yan-ping
authors.initials: YP
authors.lastname: Zhao
authors.affiliation: 3 Department of Radiology, Peking Union Medical College Hospital , Beijing, China .
authors.forename: Bo
authors.initials: B
authors.lastname: Hou
authors.affiliation: 1 Brain Imaging and Analysis Center, Duke University Medical Center , Durham, North Carolina.|5 Department of Radiology, Duke University Medical Center , Durham, North Carolina.
authors.forename: Nan-kuei
authors.initials: NK
authors.lastname: Chen
authors.affiliation: 3 Department of Radiology, Peking Union Medical College Hospital , Beijing, China .
authors.forename: Feng
authors.initials: F
authors.lastname: Feng
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000473:pathology* / Q000503:physiopathology; D009415:Nerve Net / Q000503:physiopathology; D009434:Neural Pathways / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation / Q000379:methods
keywords: Monte-Carlo simulation; Unified Multiple System Atrophy Rating Scale; cerebellar network; default mode network; limbic network; multiple system atrophy; repetitive transcranial magnetic stimulation; resting-state functional connectivity