Therapeutic effect of low-requency repetitive transcranial magnetic stimulation on Parkinson's disease associated with pain

Abstract

Objective To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation (rTMS) on Parkinson's disease (PD) patients associated with pain. Methods Fifty-six PD patients associated with pain were enrolled from June 2016 to June 2018. They were given conventional drug treatment and sham stimulation (control group, N = 28) or low-frequency (0.50 Hz) rTMS on the basis of conventional drug treatment (rTMS group, N = 28). The Unified Parkinson's Disease Rating Scale (UPDRS), Visual Analogue Scale (VAS), King's Parkinson Disease Pain Scale (KPPS) and Hamilton Depression Rating Scale-24 Items (HAMD-24) were used to evaluate the therapeutic effect and adverse events were recorded. Results The VAS (F = 15.398, P = 0.000) and KPPS scores (F = 13.483, P = 0.001) after treatment were significantly lower than before treatment in 2 groups, in which the KPPS only had lower scores of skeletal muscle pain (F = 8.245, P = 0.008), chronic pain (F= 7.376, P = 0.007) and nerve root pain (F = 3.156, P = 0.008). Compared with control group, the VAS (F = 6.237, P = 0.045) and KPPS scores (F = 343.872, P = 0.000) after treatment were lower in the rTMS group, in which the KPPS only had lower scores of skeletal muscle pain (F = 7.145, P = 0.020) and chronic pain (F = 6.325, P = 0.014). There were one case of transient blood pressure elevation and one case of transient headache in rTMS group during treatment. There was no significant difference in the incidence of adverse events between 2 groups [7.14% (2/28) vs. 0 (0/28); adjusted χ² = 0.519, P = 0.471]. Conclusions The effect of low-frequency rTMS for PD with pain is evident, especially to relieve skeletal muscle pain and chronic pain. The long-term effect needs further observation, and the safety is good, while the mechanism of action is still unclear.

DOI: 10.3969/j.issn.1672-6731.2019.06.010