Personalized Accelerated Brain Stimulation and Walking Training for Freezing of Gait in Parkinsons Disease in Adults Aged 50 to 80

What this Trial Is About

Researchers are evaluating a personalized brain stimulation method called repetitive transcranial magnetic stimulation rTMS combined with walking exercises to help people with Parkinsons disease who experience freezing of gait FOG. FOG is a disabling symptom where a person temporarily feels stuck and unable to start walking. This study aims to find out if this combined approach is practical, tolerable, and shows early signs of improving walking and reducing freezing episodes in this group. Participants will receive a personalized, accelerated course of continuous theta burst stimulation cTBS targeting a specific brain area called the supplementary motor area SMA, guided by each persons brain imaging MRI. They will undergo 6 treatment visits over 2 weeks, each day receiving 8 rTMS sessions. After each stimulation block, participants will do 30 minutes of walking exercises that include cognitive tasks. Researchers will evaluate safety, tolerability, adherence, walking performance, and brain changes using clinical scales, motor responses, and MRI before and after the intervention. Participants will attend up to 15 study visits over about 16 weeks, including brain imaging before and after treatment. They will be assessed on walking ability, Parkinsons symptoms, and brain response to stimulation. Walking will be videotaped with motion sensors for detailed analysis. Questionnaires on symptoms, safety, and tolerability will also be completed. The study monitors tolerability immediately after each stimulation session and adherence throughout the total study period to understand the interventions impact and feasibility.

Accelerated TMS for Freezing of Gait in Parkinson's Disease