Trans-Spinal Theta Burst Magnetic Stimulation in Parkinson's Disease and Gait Disorders

Background: Gait disorders in patients with Parkinson's disease (PD) can become disabling with disease progression without effective treatment. Objectives: To investigate the efficacy of intermittent θ burst trans-spinal magnetic stimulation (TsMS) in PD patients with gait and balance disorders. Methods: This was a randomized, parallel, double-blind, controlled trial. Active or sham TsMS was applied at third thoracic vertebra with 100% of the trans-spinal motor threshold, during 5 consecutive days. Participants were evaluated at baseline, immediately after last session, 1 and 4 weeks after last session. Primary outcome was Total Timed Up and Go (TUG) values comparing active versus sham phases 1 week after intervention. The secondary outcome measurements consisted of motor, gait and balance scales, and questionnaires for quality of life and cognition. Results: Thirty-three patients were included, average age 68.5 (6.4) years in active group and 70.3 (6.3) years in sham group. In active group, Total TUG mean baseline was 107.18 (95% CI, 52.1–116.1), and 1 week after stimulation was 93.0 (95% CI, 50.7–135.3); sham group, Total TUG mean baseline was 101.2 (95% CI, 47.1–155.3) and 1 week after stimulation 75.2 (95% CI 34.0–116.4), P = 0.54. Similarly, intervention had no significant effects on secondary outcome measurements. During stimulation period, five patients presented with mild side effects (three in active group and two in sham group). Discussion: TsMS did not significantly improve gait or balance analysis in patients with PD and gait disorders. The protocol was safe and well tolerated.