Treatment of articulatory dysfunction in Parkinson's disease using repetitive transcranial magnetic stimulation

Abstract

Background and purpose: Neuroimaging has demonstrated that improved speech outcomes in Parkinson's Disease (PD) subsequent to behavioural treatment approaches are associated with increased activity in the motor and pre-motor cortex. High-frequency repetitive transcranial magnetic stimulation (rTMS) is capable of modulating cortical activity and has been reported to have significant benefit to general motor function in PD. It is possible that high-frequency rTMS may also have beneficial outcomes on speech production in PD. Methods: High-frequency (5Hz) rTMS was applied to 10 active stimulation and 10 sham placebo patients for 10min/day (3000 pulses), for 10days and speech outcome measures and lingual kinematic parameters recorded at baseline and 1week, 2 and 12months post-stimulation. Results: The findings demonstrated positive treatment-related changes observed in the active rTMS group when compared to the sham placebo control group at 2 and 12months post-stimulation in speech intelligibility, communication efficiency ratio, maximum velocity of tongue movements and distance of tongue movements. Conclusion: The results support the use of high-frequency rTMS as a therapeutic tool for the treatment of articulatory dysfunction in PD. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.