Issue 24-4, 2025

Original article

https://doi.org/10.38025/2078-1962-2025-24-4-76-88

Intermittent Theta Burst Stimulation of the Primary Motor Cortex in the Correction of Motor Symptoms in Parkinson's Disease: a Randomized Controlled Study

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ORCIDGeorgii A. Kotsoev*, ORCIDEkaterina Yu. Fedotov, ORCIDIlya S. Bakulina, ORCIDAlexandra G. Poydasheva, ORCIDDmitry Yu. Lagoda, ORCIDAlfiia Kh. Zabirova, ORCIDNatalia A. Suponeva

Russian Сenter of Neurology and Neurosciences, Moscow, Russia


ABSTRACT

INTRODUCTION.  Postural disorders are a significant issue among Parkinson’s disease (PD) patients. Therapeutic transcranial magnetic stimulation (tTMS), specifically theta burst stimulation (TBS) protocols, is a promising rehabilitation method. Though tTMS efficacy in terms of motor improvement was shown, its efficacy for postural disorders treatment is questionable.

AIM.  To study the efficacy of bilateral primary motor core (M1) intermittent theta burst stimulation (iTBS) in PD patients.

MATERIALS AND METHODS.  24 PD patients, aged 42–75 years, with II and III Hoehn — Yahr stages were selected as part of this double-blinded, sham-controlled, randomized study. 10 sessions were performed both in active (M1 group) and sham (sham group) stimulation. All tests were performed both in off- and on- states, 4 times altogether: before and shortly after the course, then 1 and 3 months after the course. MDS-UPDRS, Berg balance scale, 10-meter walking test and stabilometric tests (Romberg test and dynamic stability test), performed with the Stabilan-01-2 complex, were used as assessment tools. Statistical analysis was performed with the IBM SPSS Statistics 27.

RESULTS AND DISCUSSION.  In M1 group there was a short-term motor improvement by 5 points (12.6 %) according to part III of MDS UPDRS in off state, and a long-term postural stability improvement in both states. Stabilometry results showed long-term improvement in dynamic stability test in M1 group in both states; the only significant group effect was also found. Adverse events (AE) did not significantly differ in prevalence and severity between the two groups; no life-threatening AE were observed. M1 iTBS has a moderate positive effect on motor and postural disorders in PD patients. The observed trends (mostly off state improvement and postural stability improvement) lead to suggestion of stimulation acting through both dopaminergic and dopamine-independent pathways. The protocol appears to be safe and tolerable.

CONCLUSION.  Bilateral M1 iTBS does not appear to have a definite effect on motor and postural disorders in PD patients. Nevertheless, given its tendency to have a positive effect and its good safety and tolerability profile, further research is essential.


KEYWORDS: Parkinson’s disease, transcranial magnetic stimulation, primary motor core, physical rehabilitation

FOR CITATION:

Kotsoev G.A., Fedotova E.Yu., Bakulin I.S., Poydasheva A.G., Lagoda D.Yu., Zabirova A.Kh., Suponeva N.A. Intermittent Theta Burst Stimulation of the Primary Motor Cortex in the Correction of Motor Symptoms in Parkinson’s Disease: a Randomized Controlled Study. Bulletin of Rehabilitation Medicine. 2025; 24(4):76–88. https://doi.org/10.38025/2078-1962-2025-24-4-76-88 (In Russ.). 

FOR CORRESPONDENCE:

Georgii A. Kotsoev, Е-mail: kotsoev@neurology.ru


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.