Theta burst stimulation over premotor cortex in Parkinson's disease: an explorative study on manual dexterity.
Dorsal pre-motor cortex (PMd) is thought to play a role in fine motor control. The aim of the present study was to investigate whether inhibitory or excitatory stimulation of PMd would have an impact on manual dexterity in Parkinson's disease (PD). Fifteen patients with PD participated in this study. High resolution structural MRI was used for neuro-navigated TBS. Participants were targeted with one train of TBS in three experimental sessions: sham stimulation over vertex, continuous TBS (cTBS) over PMd and intermittent TBS (iTBS) over PMd, respectively. Dexterity was measured by a coin rotation task (CRT), which is a valid measure to detect limb kinetic apraxia (LKA). Neither cTBS or iTBS significantly interfered with CRT. Post hoc sub-analysis in a group of PD patients (n = 5) with stronger baseline impairment, indicating LKA, revealed further deterioration of dexterous performance for the cTBS condition (p = 0.04). This sham controlled pilot study demonstrates that TBS over PMd does not significantly interfere with dexterity in PD. However, patients with dexterous impairment qualifying for LKA may be more susceptible to TBS.
Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Lucerne, Switzerland.|Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.|ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Tim
T
Vanbellingen
Support Center for Advanced Neuroimaging (SCAN), Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, Bern, Switzerland.
Manuela
M
Wapp
University Hospital of Psychiatry, Bern, Switzerland.
Katharina
K
Stegmayer
Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.
Manuel
M
Bertschi
Support Center for Advanced Neuroimaging (SCAN), Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, Bern, Switzerland.
Eugenio
E
Abela
Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Lucerne, Switzerland.
Stefanie
S
Kübel
Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Lucerne, Switzerland.|Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.|ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Thomas
T
Nyffeler
Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.|ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
René
R
Müri
University Hospital of Psychiatry, Bern, Switzerland.
Sebastian
S
Walther
ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.|Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland.
Tobias
T
Nef
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Mark
M
Hallett
Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Lucerne, Switzerland. stephan.bohlhalter@luks.ch.|Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland. stephan.bohlhalter@luks.ch.
Stephan
S
Bohlhalter
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000000981:diagnostic imaging / Q000502:physiology*; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D011597:Psychomotor Performance / Q000502:physiology*; D013826:Theta Rhythm / Q000502:physiology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
Coin rotation; Limb kinetic apraxia; Manual dexterity; Parkinson’s disease; Premotor cortex